Long-term Outcome of Open Synovectomy with Radial Head Resection for Rheumatoid Elbow

Abstract

Background: We reviewed our surgical results of open synovectomy with radial head resection for rheumatoid elbow. Methods: We reviewed the 20 patients (22 elbows) underwent open synovectomy for rheumatoid elbows retrospectively. The minimum follow-up period is over 10 years, and the average was 13 years 4 months. Surgical outcomes were evaluated using the VAS pain scale, range of motion, and radiologic outcomes including Larsen’s grade and carrying angle. Results: The mean VAS score was 39 (range, 10–90) at last follow-up. The only one patient underwent revision surgery. The mean flexion-extension range of elbow was -28°–112° and arc of motion was 82° before surgery. The mean flexion-extension range of elbow was -23°–114°, and arc of motion was 90° at last follow-up. Radiologic findings of nine elbows in 21 elbows worsened at last follow-up according to the Larsen–s grade. Carrying angle increased by mean 4.2°, and it increased by 10° or more in four elbows. Conclusions: Our results show that open synovectomy with radial head resection resulted in functional motion maintenance and pain control for a long time, but often resulted in an elbow valgus deformity. Our findings suggest open synovectomy can be considered as palliative treatment for painful rheumatoid elbow.