Limited extension after linked total elbow arthroplasty in patients with rheumatoid arthritis.
OBJECTIVE
Total elbow arthroplasty (TEA) has become an established procedure to relieve pain and to increase the range of motion of the destructed elbow in patients with rheumatoid arthritis (RA). However, some patients still have limited extension after TEA, and the causes of limited extension after TEA have yet to be elucidated.


METHODS
To examine whether widening of the joint space can cause such limited extension, we retrospectively analyzed 55 cases of linked TEA in patients with RA. There were seven male and 40 female with a mean age of 63.8 years (range, 30-80 years) and a mean follow-up of 7.5 ± 4.2 years (range, 2.5-15.6 years). The Mayo Elbow Performance Score (MEPS) and radiological measurements were recorded. Widening of the joint space was calculated by subtracting the length measured on postoperative radiograph from preoperative radiograph.


RESULTS
MEPS and range of motion were significantly improved after surgery except for extension. The degree of extension was significantly correlated with radiological widening of the joint space in the limited extension group. Correlation analyses showed that postoperative limited extension was correlated with lower MEPS daily function.


CONCLUSIONS
Limited extension after linked TEA is partly derived from perioperative widening of the joint space and potentially limits daily function in patients with RA.
a Department of Orthopedic Surgery , Kyoto University Graduate School of Medicine , Kyoto , Japan .
Hiroko
H
Ogino
a Department of Orthopedic Surgery , Kyoto University Graduate School of Medicine , Kyoto , Japan .
Hiromu
H
Ito
a Department of Orthopedic Surgery , Kyoto University Graduate School of Medicine , Kyoto , Japan .|b Department of the Control for Rheumatic Diseases , Kyoto University Graduate School of Medicine , Kyoto , Japan , and.
Moritoshi
M
Furu
a Department of Orthopedic Surgery , Kyoto University Graduate School of Medicine , Kyoto , Japan .|b Department of the Control for Rheumatic Diseases , Kyoto University Graduate School of Medicine , Kyoto , Japan , and.
Masahiro
M
Ishikawa
c The Center for Innovation in Immunoregulative Technology and Therapeutics , Kyoto University Graduate School of Medicine , Kyoto , Japan.
Hiroyuki
H
Yoshitomi
a Department of Orthopedic Surgery , Kyoto University Graduate School of Medicine , Kyoto , Japan .
Shuichi
S
Matsuda
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D057929:Arthroplasty, Replacement, Elbow / Q000379:methods*; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
Daily function; Extension loss; Postoperative outcome; Rheumatoid arthritis; Total elbow arthroplasty