{"title":"全肘关节置换术后肘关节神经性病变早期松动1例。","authors":"Hiroshi Nakamura, Takuji Iwamoto, Hiroo Kimura, Taku Suzuki, Noboru Matsumura, Morio Matsumoto, Masaya Nakamura","doi":"10.1093/mrcr/rxac094","DOIUrl":null,"url":null,"abstract":"<p><p>We reported the case of a 65-year-old woman who presented with neuropathic arthropathy of the elbow and had undergone cervical spinal cord tumour resection at 32 years of age. Open synovectomy with free-body resection was performed; however, the instability of the elbow joint rapidly progressed. Therefore, we performed total elbow arthroplasty (TEA) using a linked-type prosthesis. However, the humeral stem became severely loosened 1 year after arthroplasty. Furthermore, a periprosthetic humeral fracture developed due to a minor trauma. A revision TEA using a long-stem prosthesis was performed 4 years after the primary TEA. Radiographs taken 2 years after the revision surgery showed no evidence of implant loosening. In this case, early postoperative loosening occurred despite the use of a linked-type prosthesis and an appropriate cementing technique, suggesting that normal implants may not provide sufficient fixation for neuropathic arthropathy of the elbow. Since surgery for neuropathic arthropathy generally has a poor prognosis, surgical interventions including TEA should be carefully considered.</p>","PeriodicalId":18677,"journal":{"name":"Modern Rheumatology Case Reports","volume":"7 2","pages":"480-482"},"PeriodicalIF":0.0000,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A case of neuropathic arthropathy of the elbow with early loosening after total elbow arthroplasty.\",\"authors\":\"Hiroshi Nakamura, Takuji Iwamoto, Hiroo Kimura, Taku Suzuki, Noboru Matsumura, Morio Matsumoto, Masaya Nakamura\",\"doi\":\"10.1093/mrcr/rxac094\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>We reported the case of a 65-year-old woman who presented with neuropathic arthropathy of the elbow and had undergone cervical spinal cord tumour resection at 32 years of age. Open synovectomy with free-body resection was performed; however, the instability of the elbow joint rapidly progressed. Therefore, we performed total elbow arthroplasty (TEA) using a linked-type prosthesis. However, the humeral stem became severely loosened 1 year after arthroplasty. Furthermore, a periprosthetic humeral fracture developed due to a minor trauma. A revision TEA using a long-stem prosthesis was performed 4 years after the primary TEA. Radiographs taken 2 years after the revision surgery showed no evidence of implant loosening. In this case, early postoperative loosening occurred despite the use of a linked-type prosthesis and an appropriate cementing technique, suggesting that normal implants may not provide sufficient fixation for neuropathic arthropathy of the elbow. Since surgery for neuropathic arthropathy generally has a poor prognosis, surgical interventions including TEA should be carefully considered.</p>\",\"PeriodicalId\":18677,\"journal\":{\"name\":\"Modern Rheumatology Case Reports\",\"volume\":\"7 2\",\"pages\":\"480-482\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-06-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Modern Rheumatology Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/mrcr/rxac094\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Modern Rheumatology Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/mrcr/rxac094","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
A case of neuropathic arthropathy of the elbow with early loosening after total elbow arthroplasty.
We reported the case of a 65-year-old woman who presented with neuropathic arthropathy of the elbow and had undergone cervical spinal cord tumour resection at 32 years of age. Open synovectomy with free-body resection was performed; however, the instability of the elbow joint rapidly progressed. Therefore, we performed total elbow arthroplasty (TEA) using a linked-type prosthesis. However, the humeral stem became severely loosened 1 year after arthroplasty. Furthermore, a periprosthetic humeral fracture developed due to a minor trauma. A revision TEA using a long-stem prosthesis was performed 4 years after the primary TEA. Radiographs taken 2 years after the revision surgery showed no evidence of implant loosening. In this case, early postoperative loosening occurred despite the use of a linked-type prosthesis and an appropriate cementing technique, suggesting that normal implants may not provide sufficient fixation for neuropathic arthropathy of the elbow. Since surgery for neuropathic arthropathy generally has a poor prognosis, surgical interventions including TEA should be carefully considered.