Non-constrained elbow arthroplasty for mutilans deformity in rheumatoid arthritis: a report of six cases.
Six highly unstable elbows with severe bone loss due to rheumatoid arthritis were replaced by a non-constrained, unlinked prosthesis. Bone defects were filled with autogenous bone grafts. The mean follow-up was 4.5 years (2 to 8). The clinical results were excellent in four elbows and good in two, with good varus-valgus stability in all. Radiological follow-up showed no appreciable signs of loosening, and the bone grafts had retained most of their original size, with minimal resorption. There were no major complications such as dislocation, skin necrosis, infection or ulnar neuropathy. The study has shown that the so-called mutilans elbow can be successfully replaced using a properly selected type of non-constrained, unlinked prosthesis with bone grafting of the major defects.
Kudo
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Orthopaedic Section, Sagamihara National Hospital, Sagamihara City, Kanagawa, Japan.
D000497:Alloys; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000601:surgery*; D019643:Arthroplasty, Replacement; D001843:Bone Cements; D001862:Bone Resorption / Q000601:surgery; D016025:Bone Transplantation; D002484:Cementation; D002858:Chromium Alloys; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000601:surgery; D016916:Joint Deformities, Acquired / Q000000981:diagnostic imaging / Q000601:surgery*; D007593:Joint Instability / Q000601:surgery; D007595:Joint Prosthesis; D008875:Middle Aged; D018579:Patient Selection; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D014025:Titanium; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014457:Ulna / Q000601:surgery
D000497:Alloys; D001843:Bone Cements; D002858:Chromium Alloys; C031462:titanium alloy (TiAl6V4); D014025:Titanium