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Artroplastia total do cotovelo

Authors: Lima, Ana Sofia; Henriques, Rita; Chambel, André; Arvela, Jorge; Martins, Samuel; Sarmento, Marco;

Artroplastia total do cotovelo

Abstract

Objetivo: Descrever os resultados clínicos, radiográficos e funcionais das artroplastias totais do cotovelo (ATC), bem como as suas complicações, e compará-los com a literatura publicada. Materiais e Métodos: Estudo retrospetivo de casos de ATC num período de 10 anos (2006 a 2016). Os dados demográficos incluíram idade, género, patologia primária, tipo de ATC (primária ou de revisão), data da cirurgia primária, lado cirúrgico, data e causa das reoperações e microrganismos isolados nos casos de infeções. Os resultados clínicos compreenderam a amplitude de movimentos, resultados funcionais e complicações. Os resultados funcionais foram avaliados através do Mayo Elbow Performance Score (MEPS) e do Disabilities of the Arm, Shoulder and Hand (DASH). Resultados: Incluíram-se 25 doentes (26 ATCs) neste estudo, 20 mulheres e 6 homens. A idade média à data da cirurgia primária foi de 56 anos. As indicações para ATC foram artrose primária (29%), artrose secundária (63%), fratura distal do úmero (4%) e pseudartrose (4%). As complicações incluíram infeção (15%), osteólise (12%), falência mecânica (12%), instabilidade (12%), desgaste do polietileno (4%), neuropatia cubital (15%), insuficiência tricipital (4%), calcificações (8%) e fraturas intraoperatórias (8%). O Staphylococcus aureus foi isolado em 67% das infeções. A pontuação média do MEPS foi 71 e do DASH foi 60. Conclusões: A maioria dos resultados está de acordo com a literatura publicada. Grande parte dos doentes submetidos a ATC experiencia uma melhoria funcional substancial e alívio significativo da dor, e muitos retomam as atividades da vida diária. Objective: To describe clinical, radiographic and functional results of total elbow arthroplasties (TEA), as well as their complications, and to compare them with published literature. Materials and Methods: Retrospective study of TEA cases over a period of 10 years (2006 to 2016). Demographic data collected included age, gender, primary pathology, type of TEA (primary or revision), date of primary surgery, surgical side, date and cause of reoperations and isolated microorganisms in infections. Clinical outcomes comprised range of motion, functional outcome and overall complications. Functional outcomes were assessed by means of the Mayo Elbow Performance Score (MEPS) and the Disabilities of the Arm, Shoulder and Hand (DASH). Results: 25 patients (26 TEAs) were included in this study, 20 females and 6 males. Mean age at the time of primary surgery was 56 years old. Indications for TEA were primary osteoarthritis (29%), secondary osteoarthritis (63%), distal humerus fracture (4%) and fracture nonunion (4%). Complications included infection (15%), aseptic loosening (12%), mechanical failure (12%), instability (12%), polyethylene wear (4%), ulnar neuropathy (15%), triceps insufficiency (4%), calcifications (8%) and intra-operative fractures (8%). A Staphylococcus aureus was isolated in 67% of the cases of infection. Mean MEPS score was 71 and mean DASH score was 60. Conclusions: Most of our results are in agreement with published literature. Most patients who undergo a TEA experience substantial functional improvement and significant pain relief, and many are able to resume activities of daily living.

Keywords

infeção, osteólise, total arthroplasty, aseptic loosening, Elbow, Cotovelo, infection, artroplastia total

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
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