title: Short-term results of the PROSNAP linked elbow prosthesis with a snap-in structure and modular flange for the reconstruction of severely damaged rheumatoid elbows.
abstract: BACKGROUND
  We aimed to evaluate the early clinical results of the reconstruction of problematic elbow joints due to rheumatoid arthritis (RA) using a PROSNAP linked elbow prosthesis (Kyocera Medical, Osaka, Japan) for total elbow arthroplasty.
  
  
  METHODS
  Seventeen elbows in 14 RA patients were replaced with a PROSNAP elbow with cement fixation. The patients comprised 1 man and 13 women, with a mean age of 63.9 years (range, 52-83 years) at the time of surgery. The preoperative conditions of the elbows were arthritis mutilans (n = 10), an ankylosed or stiff elbow with a preoperative range of motion of 45° or less (n = 4), and loosening of a primary total elbow arthroplasty (n = 3). The mean follow-up period was 47.7 months (range, 32-69 months), with a 100% follow-up rate. The clinical outcome of the elbows was evaluated by the Mayo Elbow Performance Index (maximum, 100 points).
  
  
  RESULTS
  The mean postoperative Mayo Elbow Performance Index score improved from 57.6 points to 97.1 points. Preoperatively, 3 of the 17 elbows were judged as good, 7 as fair, and 7 as poor; at final follow-up, 16 elbows were judged as excellent and 1 as good. Complications were noted in 1 elbow (6%), which had undergone a postoperative fracture.
  
  
  CONCLUSIONS
  The PROSNAP elbow prosthesis can be safely implanted through a relatively easy procedure and provides satisfactory short-term clinical outcomes for the reconstruction of severely damaged RA elbows.
  
  
  METHODS
  Level IV, case series, treatment study.
authors.affiliation: Department of Human Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan; Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan. Electronic address: knishida@md.okayama-u.ac.jp.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Nishida
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hashizume
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Nakahara
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Ozawa
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan.
authors.forename: Ryozo
authors.initials: R
authors.lastname: Harada
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Machida
authors.affiliation: Department of Orthopaedic Surgery, Kurashiki Sweet Hospital, Kurashiki City, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nasu
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan.
authors.forename: Toshihumi
authors.initials: T
authors.lastname: Ozaki
authors.affiliation: Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama City, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000844:Ankylosis / Q000601:surgery; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D057929:Arthroplasty, Replacement, Elbow / Q000295:instrumentation*; D004551:Elbow Joint / Q000601:surgery*; D058569:Elbow Prosthesis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: PROSNAP; Rheumatoid arthritis; arthroplasty; elbow; linked elbow