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A 5–22-year follow-up study of stemmed alumina ceramic total elbow arthroplasties with cement fixation for patients with rheumatoid arthritis

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

We determined mid to long-term results of total elbow arthroplasty (TEA) by use of unlinked elbow prostheses with solid alumina ceramic trochleae, and ceramic ulnar stems (stemmed Kyocera type I; SKC-I) for patients with rheumatoid arthritis.

Patients and methods

Fifty-four elbows of 39 patients were available for detailed clinical and radiographic review after a follow-up period of at least 5 years. The mean follow-up period was 12.6 years (range 5–22 years). Clinical condition before and after surgery was assessed by use of a modified version of the Mayo Elbow Performance Score (MEPS; 0–100 points) and a Japan Orthopaedic Association Elbow score (JOA score; 0–100 points). The radiographs were reviewed and loosening was defined as a progressive radiolucent line >1 mm wide that was completely circumferential around the prosthesis. Clinical records of post-operative events affecting the elbows were used for survival analysis of the prostheses using the Kaplan–Meier method.

Results

The average modified MEPS and JOA scores improved significantly from 39.7 ± 14.3 to 44.7 ± 9.4, respectively, pre-operatively, to 89.7 ± 15.4 and 83.1 ± 12.8, respectively, post-operatively (P < 0.0001). The functional assessment score also improved from 4.9 ± 2.8 to 8.5 ± 3.3 points (P < 0.0001). With loosening or implant revision defined as end points, the likelihood of survival of the prosthesis for up to 20 years was 92.6 % (95 % confidence interval (CI), 85.6–100.0) or 86.3 % (95 % CI 75.0–97.6), respectively.

Conclusion

Satisfactory clinical results were obtained after TEA using SKC-I prostheses, which provided excellent pain relief and functional range of motion. The results of our study reveal the high reliability over a long period of the cemented SKC-I prosthesis with an alumina ceramic component.

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Conflict of interest

The authors declare that they have no conflict of interest. In the Department of Orthopaedic Surgery (Head of department, Professor Toshifumi Ozaki), Okayama University, there is a small department named "Department of Medical Materials for Musculoskeletal Reconstruction" donated by the KYOCERA Medical Corporation.

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Authors and Affiliations

  1. Department of Human Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan

    Keiichiro Nishida

  2. Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

    Keiichiro Nishida, Kenzo Hashizume, Toshifumi Ozaki & Hajime Inoue

  3. Kurashiki Sweet Hospital, Okayama, Japan

    Yoshihisa Nasu

  4. Kishimoto Seikeigeka Clinic, Okayama, Japan

    Makoto Kishimoto

Authors
  1. Keiichiro Nishida
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  2. Kenzo Hashizume
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  3. Yoshihisa Nasu
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  4. Makoto Kishimoto
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  5. Toshifumi Ozaki
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  6. Hajime Inoue
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Correspondence to Keiichiro Nishida.

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Nishida, K., Hashizume, K., Nasu, Y. et al. A 5–22-year follow-up study of stemmed alumina ceramic total elbow arthroplasties with cement fixation for patients with rheumatoid arthritis. J Orthop Sci 19, 55–63 (2014). https://doi.org/10.1007/s00776-013-0492-0

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