Clinical Results of Radical Synovectomy with Muscle Release for Rheumatoid Elbow with Severe Destruction Beyond Larsen Grade III.

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Radical synovectomy with muscle release at the lateral humeral epicondyle and excision of the radial head was performed on 70 elbows of 56 rheumatoid patients. The mean age of the patients was 51.4 years (range 26 to 75) at the time of surgery. The mean follow-up period was 6.7 years (range 2 to 21) . Patients were satisfied with the surgical results in 65 out of 70 elbows. The mean elbow score, evaluated using criteria of Yokohama City University, improved from a preoperative 46.4 points to 76.5 at follow-up. The mean arc of motion improved from a preoperative 70.9 degrees to a postoperative 101.4 degrees. Radiologically, the Larsen Grade was advanced in 26 out of 70 elbows. However, there was no difference in elbow score between groups regardless of grade. There were no severe complications. Radical synovectomy with muscle release at the lateral humeral epicondyle with excision of the radial head was concluded to be a treatment of choice for rheumatoid elbows of advanced grades.
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