Shuai Chen1, Jiazhi Liu1,2, Jiangyu Cai3, Wei Zheng1, Zhiwei Li1, Wei Chen1, Cunyi Fan4. 1. Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, People's Republic of China. 2. Taishan Medical University, 619 Changcheng Road, Taian, 271016, People's Republic of China. 3. Fudan University Sports Medicine Center & Department of Sports Medicine and Arthroscopy Surgery, Huashan Hospital, Fudan University, No. 12, Middle Urumqi Road, Shanghai, 200040, People's Republic of China. 4. Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, People's Republic of China. fancunyi888@163.com.
Abstract
BACKGROUND: Heterotopic ossification (HO) may lead to complete elbow ankylosis, resulting in severe disability. The prognostic factors that may be valuable in guiding treatment of this condition have not yet been evaluated. The goals of this study were to describe the outcomes of open release for ankylosed elbow caused by HO and to analyse factors associated with clinical outcomes. METHOD: This retrospective study assessed 41 patients with ankylosed elbows treated by open release surgery. We report final clinical outcomes and analyses of the association between outcomes and clinical variables. RESULTS: Mean patient age was 36.4 years; follow-up was 36.1 months. Mean arc of motion increased from 0 to 112° post-operatively, mean pronation from 34 to 52°, supination from a mean of 51 to 76°, and Mean Mayo Elbow Performance Score (MEPS) from 42.8 to 84.2. Eight patients experienced recurrence, two of whom underwent a second operation: one for elbow instability and one for revision surgery. Linear regression analysis demonstrated that initial injury type (p = 0.020), articular surface damage (p = 0.001), coma iduringthe initial injury (p = 0.001) and concomitant radial head replacement (p = 0.029) were independent factors affecting the final MEPS. CONCLUSIONS: Satisfactory outcomes were achieved, indicating that open release is effective for ankylosed elbows. Our findings demonstrated that initial injury type, articular surface damage, coma and radial head replacement are outcome predictors affecting final outcomes.
BACKGROUND: Heterotopic ossification (HO) may lead to complete elbow ankylosis, resulting in severe disability. The prognostic factors that may be valuable in guiding treatment of this condition have not yet been evaluated. The goals of this study were to describe the outcomes of open release for ankylosed elbow caused by HO and to analyse factors associated with clinical outcomes. METHOD: This retrospective study assessed 41 patients with ankylosed elbows treated by open release surgery. We report final clinical outcomes and analyses of the association between outcomes and clinical variables. RESULTS: Mean patient age was 36.4 years; follow-up was 36.1 months. Mean arc of motion increased from 0 to 112° post-operatively, mean pronation from 34 to 52°, supination from a mean of 51 to 76°, and Mean Mayo Elbow Performance Score (MEPS) from 42.8 to 84.2. Eight patients experienced recurrence, two of whom underwent a second operation: one for elbow instability and one for revision surgery. Linear regression analysis demonstrated that initial injury type (p = 0.020), articular surface damage (p = 0.001), coma iduringthe initial injury (p = 0.001) and concomitant radial head replacement (p = 0.029) were independent factors affecting the final MEPS. CONCLUSIONS: Satisfactory outcomes were achieved, indicating that open release is effective for ankylosed elbows. Our findings demonstrated that initial injury type, articular surface damage, coma and radial head replacement are outcome predictors affecting final outcomes.
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