Comparison of short- to medium-term results of Coonrad-Morrey elbow replacement in patients with rheumatoid arthritis versus patients after elbow injuries
Karol Szyluk, Wojciech Widuchowski, Andrzej Jasiński, Bogdan Koczy, Jerzy Widuchowski
Med Sci Monit 2013; 19:18-27
Background: The aim of this study was to assess the utility of the Coonrad-Morrey elbow prosthesis in patients with severe elbow dysfunction secondary to rheumatoid arthritis (RA) or post-traumatic elbow dysfunction.
Material/Methods: The study involved 35 patients followed up for a mean of 36 months. The patients were divided into those with RA (Group I) and those with post-traumatic elbow dysfunction (Group II). Treatment outcomes were evaluated according to the Mayo Elbow Performance Score (MEPS) and the Disabilities of the Arm, Shoulder and Hand Score (Quick DASH).
Results: According to the MEPS, there were 20 (57.15%) excellent, 12 (34.3%) good, 1 (2.85%) fair, and 2 (5.7%) poor outcomes. The mean post-operative Quick-DASH score for the entire study group was 37.73 points. In subgroup analysis, the MEPS-based evaluation revealed: 14 (70%) excellent, 5 (25%) good, and 1 (5%) satisfactory outcome in Group I, versus 6 (40%) excellent, 7 (46.7%) good, and 2 (13.3%) poor outcomes in Group II. The mean Quick Dash scores were 78.64 points in Group I and 76.36 points in Group II. The final MEPS scores in Group I (p=0.000018) and Group II (p=0.00065) were most markedly influenced by reduction in elbow pain and improvement in the ability to perform activities of daily living (ADL): p=0.000018 in Group I and p=0.000713 in Group II.
Conclusions: The treatment outcomes confirm the utility of arthroplasty for severe elbow dysfunctions; they were most strongly influenced by pain reduction and improved ability to perform activities of daily living.
Keywords: Elbow Joint, elbow prosthesis, rheumatoid arthritis, distal humerus fractures