O-3-14. Treatment of ulnar neuropathy after total elbow arthroplasty (TEA) and nerve conduction test

• Published in: Clinical Neurophysiology Vol. 129; no. 5; p. e36
• Main Authors: Katayama, Yoshimi, Senda, Masuo, Kaneda, Daisuke, Hino, Tomohito, Ikeda, Yoshihiro, Ozaki, Toshihumi
• Format: Journal Article
• Language: English; Japanese
• Published: Elsevier B.V 01.05.2018; Elsevier BV
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2018.02.089

Ulnar neuropathy is one of complications of TEA (total elbow arthroplasty, incidence; 5 to 10%), yet there are not many evaluations and clinical course reports. Out of 117 patients with rheumatoid arthritis (RA) who underwent TEA, 8 patients showed numbness and muscle weakness of the ulnar nerve region after surgery, and received electromyography (EMG). EMG examinations revealed ulnar neuropathy at the elbow in 6 subjects, 5 of whom performed neurolysis. Two patients were diagnosed with cervical spondylosis. A 50-year-old female developed RA in 1998. She underwent left TEA (JACE) in June 2014. As numbness appeared, we performed EMG to her in October 2014. Delay of sensory nerve conduction velocity (SCV) was observed at cubital tunnel. In April 2015 left ulnar nerve neurolysis was performed. After that, both EMG finding and symptoms were improved. However, EMG in June 2016 again confirmed a delay in SCV and we performed a second ulnar nerve neurolysis in September 2016. Evaluations of ulnar neuropathy are important because RA also causes cervical spinal lesions such as atlantoaxial subluxation. Adhesion and scars are recognized at the elbow joint in the five patients who underwent neurolysis. Thus, it is necessary to follow up with electromyogram examination, for diagnosis of neuropathy and postoperative evaluation.