Outcome of shortened extra-small ulnar component in linked total elbow arthroplasty for patients with rheumatoid arthritis^*

^*Ethical approval for this study was granted by the ethics committee of Kyoto University Graduate School and Faculty of Medicine (E1785).

Abstract

Objective. We compared the clinical and radiological results of the 3-inch shortened ulnar stem of the extra-small component of Coonrad–Morrey prosthesis with those of the other ulnar components for patients with rheumatoid arthritis (RA).

Methods. A total of 33 Coonrad–Morrey total elbow arthroplasty (TEA) procedures were performed. Of these, 27 elbows of 25 patients with RA underwent primary TEA. The results of the clinical and radiological findings were compared between groups of patients receiving the shortened ulnar stem of extra-small components (shortened group) and of those receiving the components of the other sizes (control group).

Results. The mean follow-up was 6.2 ± 2.8 years in the shortened group and 7.2 ± 2.5 years in the control group. The Mayo elbow performance score and range of motion results were substantially improved after the operation for both groups. We encountered several peri- and postoperative complications, but no significant differences in clinical results were found between the groups. The control group had three cases of osteolysis around the implant, while the shortened group did not.

Conclusions. TEA with a shortened ulnar implant of the extra-small size of the Coonrad–Morrey prosthesis gave satisfactory mid-term results among patients with RA.

Keywords:

• Clinical outcome
• Osteolysis
• Postoperative complication
• Radiological outcome
• Rheumatoid arthritis
• Total elbow arthroplasty

Acknowledgments

We thank Professor Ryosuke Kakinoki, Department of Orthopaedic Surgery, Kinki University Graduate School of Medicine, for his valuable help. We also thank Professor Emeritus Takashi Nakamura, Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, for his tremendous support for this manuscript.

Conflict of interest

M.F. and M.I. are affiliated with a department that is supported financially by four pharmaceutical companies (Mitsubishi Tanabe Pharma Co., Bristol-Myers K.K., Chugai Pharmaceutical Co. Ltd., and Eisai Co. Ltd.). H.Y. is affiliated with a department that is supported financially by Astellas Pharma Inc. H.I. has received grant and research support from Takeda Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Co., Chugai Pharmaceutical Co. Ltd., Pfizer Japan Inc., Astellas Pharma Inc., and Daiichi Sankyo Co. Ltd. M.F. has received grant and research support from Mitsubishi Tanabe Pharma Co., Astellas Pharma Inc., and Pfizer Japan Inc. S. M. has received grant and research support from Kyocera Medical Co. Ltd., Ishihara Sangyo Kaisha Ltd., Asahi Kasei Parma Co. Ltd., Taisho Toyama Pharmaceutical Co. Ltd., Hisamitsu Pharmaceutical Co. Inc., Kaken Pharmaceutical Co. Ltd., Astellas Pharma Inc., MSD K.K., Eisai Co. Ltd., Pfizer Japan Inc., Teijin Pharma Ltd., Smith & Nephew Orthopaedics KK, Eli Lilly Japan K.K., Daiichi Sankyo Co. Ltd., and Zimmer Inc. The sponsors were not involved in the study design; in the collection, analysis, interpretation of data; in writing this manuscript; or in the decision to submit the article for publication. The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

Notes

^* Ethical approval for this study was granted by the ethics committee of Kyoto University Graduate School and Faculty of Medicine (E1785).