Abstract
A study was conducted to determine the incidence of ulnar and peripheral neuropathy
in patients with rheumatoid arthritis undergoing total elbow arthroplasty and the
effect it has on ulnar nerve function after surgery. Preoperative and postoperative
clinical and electrodiagnostic examinations were completed in 10 patients. Before
surgery 4 patients had clinical and electrophysiologic evidence of a neuropathy (2
each with a peripheral neuropathy and an ulnar neuropathy). One patient had subclinical
evidence of a chronic T-1 radiculopathy. After surgery 2 patients showed neurologic
improvement (1 had ulnar neuropathy and 1 had diabetic neuropathy). One patient who
had normal test results before surgery developed transient ulnar sensory symptoms
after surgery. An electrodiagnostic study confirmed an ulnar neuropathy that was not
detected on physical examination; the electrodiagnostic findings improved 4 months
later. We found that a large percentage of patients (40%) with rheumatoid arthritis
had evidence of ulnar or peripheral neuropathy before surgery. The presence of an
ulnar or peripheral neuropathy did not predispose patients to develop postoperative
ulnar nerve dysfunction either clinically or electrophysiologically. Preoperative
and postoperative physical and electrodiagnostic examination results correlated in
9 of the 10 patients. (J Hand Surg 2000;25A:360–364. Copyright © 2000 by the American
Society for Surgery of the Hand.)
Keywords
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References
- Total elbow arthroplasty.J Arthroplasty. 1990; 5: 359-363
- Capitellocondylar total elbow replacement for rheumatoid arthritis.J R Coll Surg Edinb. 1991; 36: 133-135
- Total elbow arthroplasty.Clin Orthop. 1984; 182: 137-142
- Complications of total elbow arthroplasty.Clin Orthop. 1982; 170: 204-212
- Complications of elbow replacement surgery.in: 2nd ed. The elbow and its disorders. : WB Saunders, Philadelphia1993: 665-666
- Capitellocondylar total elbow replacement: a long-term follow-up study.J Bone Joint Surg. 1989; 71A: 217-222
- Peripheral neuropathy associated with rheumatoid arthritis: a clinical and electrodiagnostic study of 70 consecutive rheumatoid arthritis patients.Ann Intern Med. 1965; 63: 87-99
- Ulnar neuropathies in rheumatoid arthritis.Hand. 1978; 10: 77-81
- Peripheral neuropathy in rheumatoid arthritis.BMJ. 1965; 1: 1141-1147
- Semiconstrained total elbow replacement.in: The elbow. Master techniques in orthopaedic surgery. : Raven, New York1994: 231-255
- Semiconstrained elbow replacement arthroplasty: rationale, technique, and results.in: 2nd ed. The elbow and its disorders. : WB Saunders, Philadelphia1993: 652-656
- Neurologic complications after total shoulder arthroplasty.J Shoulder Elbow Surg. 1996; 5: 53-61
- Nerve palsy associated with total hip replacement.J Bone Joint Surg. 1991; 73A: 1074-1080
- Nerve palsy after knee arthroplasty in patients with rheumatoid arthritis.Scand J Rheumatol. 1983; 12: 201-205
- Intraoperative monitoring of ulnar nerve function during replacement of the rheumatoid elbow via the lateral approach.Acta Orthop Scand. 1995; 66: 132-136
Article info
Publication history
Accepted:
October 15,
1999
Received:
November 17,
1998
Footnotes
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
**Reprint requests: Robert J. Spinner, MD, Department of Neurologic Surgery, Mayo Clinic/Mayo Foundation, Joseph 1-229E, Rochester, MN 55905.
*0363-5023/00/25A02-0005$3.00/0
**J Hand Surg 2000;25A:360–364
Identification
Copyright
© 2000 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
