Synovectomy of the elbow and radial head excision in rheumatoid arthritis. Predictive factors and long-term outcome.
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 whic...
| Main Authors: | , , , , , |
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| Formato: | Journal article |
| Idioma: | English |
| Publicado: |
1997
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| _version_ | 1826295899255472128 |
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| author | Gendi, N Axon, J Carr, A Pile, K Burge, P Mowat, A |
| author_facet | Gendi, N Axon, J Carr, A Pile, K Burge, P Mowat, A |
| author_sort | Gendi, N |
| collection | OXFORD |
| description | 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 degrees in supination-pronation and 11 degrees 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. |
| first_indexed | 2024-03-07T04:08:03Z |
| format | Journal article |
| id | oxford-uuid:c6e2ffdb-d131-4a70-a158-8d6c2c929eff |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T04:08:03Z |
| publishDate | 1997 |
| record_format | dspace |
| spelling | oxford-uuid:c6e2ffdb-d131-4a70-a158-8d6c2c929eff2022-03-27T06:41:06ZSynovectomy of the elbow and radial head excision in rheumatoid arthritis. Predictive factors and long-term outcome.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c6e2ffdb-d131-4a70-a158-8d6c2c929effEnglishSymplectic Elements at Oxford1997Gendi, NAxon, JCarr, APile, KBurge, PMowat, AWe 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 degrees in supination-pronation and 11 degrees 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. |
| spellingShingle | Gendi, N Axon, J Carr, A Pile, K Burge, P Mowat, A Synovectomy of the elbow and radial head excision in rheumatoid arthritis. Predictive factors and long-term outcome. |
| title | Synovectomy of the elbow and radial head excision in rheumatoid arthritis. Predictive factors and long-term outcome. |
| title_full | Synovectomy of the elbow and radial head excision in rheumatoid arthritis. Predictive factors and long-term outcome. |
| title_fullStr | Synovectomy of the elbow and radial head excision in rheumatoid arthritis. Predictive factors and long-term outcome. |
| title_full_unstemmed | Synovectomy of the elbow and radial head excision in rheumatoid arthritis. Predictive factors and long-term outcome. |
| title_short | Synovectomy of the elbow and radial head excision in rheumatoid arthritis. Predictive factors and long-term outcome. |
| title_sort | synovectomy of the elbow and radial head excision in rheumatoid arthritis predictive factors and long term outcome |
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