Synovectomy of the elbow and radial head excision in rheumatoid arthritis
| dc.contributor.author | Gendi, Nagui S. T. | en |
| dc.contributor.author | Axon, Jeremy M. C. | en |
| dc.contributor.author | Carr, Andrew J. | en |
| dc.contributor.author | Pile, Kevin D. | en |
| dc.contributor.author | Burge, Peter D. | en |
| dc.contributor.author | Mowat, Alastair G. | en |
| dc.date.issued | 1997 | en |
| dc.description.abstract | We carried out a survival analysis of elbow synovectomy (ES) and excision of the radial head (RHE) performed on 171 rheumatoid elbows. The failure criteria were revision surgery (performed or desired) and/or the presence of significant or severe pain. The cumulative survival was 81% at one year which thereafter decreased by an average of 2.6% per year. The strongest predictor for success was a low preoperative range of supination-pronation when corresponding survival curves were compared. A low range of flexion-extension also predicted failure. Combining both factors gave better prediction (failure: 6.3% v 67%), but a long duration of elbow symptoms before surgery predicted failure (72%, p = 0.04). At review, there was a mean gain of 50° in supination-pronation and 11° in flexion-extension; both correlated with success. Failure correlated with recurrence of synovitis, elbow instability, ulnar neuropathy, poor general mobility and poor upper-limb function. The last was independently affected by the severity of RA in the ipsilateral shoulder. Our findings show that although the short-term result of ES and RHE in rheumatoid arthritis is good, the long-term outcome is poor except in a subgroup with more than 50% limitation of forearm rotation. | en |
| dc.description.statementofresponsibility | Nagui S. T. Gendi, Jeremy M. C. Axon, Andrew J. Carr, Kevin D. Pile, Peter D. Burge, Alastair G. Mowat | en |
| dc.identifier.citation | Journal of Bone and Joint Surgery. 79-B(6):918-923 | en |
| dc.identifier.uri | http://hdl.handle.net/2440/8928 | |
| dc.language.iso | en | en |
| dc.rights | © 1997 British Editorial Society of Bone and Joint Surgery | en |
| dc.source.uri | http://www.bjj.boneandjoint.org.uk/content/79-B/6/918.abstract | en |
| dc.title | Synovectomy of the elbow and radial head excision in rheumatoid arthritis | en |
| dc.type | Journal article | en |