Mid-term results of alumina ceramic unlinked total elbow arthroplasty with cement fixation for patients with rheumatoid arthritis

Nishida, Keiichiro; Hashizume, Kenzo; Nasu, Y.; Ozawa, Masatsugu; Fujiwara, Kazuo; Inoue, Hajime; Ozaki, Toshifumi

doi:10.1302/0301-620x.100b8.bjj-2017-1451.r1

Cited by 13 publications

(18 citation statements)

References 49 publications

(41 reference statements)

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“…Among the records of 353 elbows treated by primary TEA for RA between 1986 and 2019, 298 elbows were replaced by unlinked prostheses. The unlinked implants used in our institution for the reconstruction of RA elbows were the stemmed Kyocera type I (SKC-I; Kyocera, Japan), 10 the J-alumina ceramic elbow (JACE; Kyocera), 11 and Kudo (type-5; Zimmer Biomet, USA). 8 , 9 There were 105 elbows by SKC-I, 177 elbows by JACE, and 16 elbows by Kudo type-5.…”

Section: Methodsmentioning

confidence: 99%

“…Mid- to long-term clinical results of the above two alumina ceramic implants with cement fixation have been reported separately. 10 , 11 Of these, nine elbows of seven patients and 13 elbows of 12 patients, who underwent TEA using SKC-I and JACE, respectively, were included in the current study. One patient with SKC-I was lost to follow-up at 13 years after surgery due to moving to another prefecture.…”

Section: Methodsmentioning

confidence: 99%

“…The distal part of the thick tendinous portion of the long head was separated into two layers, and the musculotendinous insertion was released from the tip of the olecranon in a reverse T manner, as previously described. 11 For SKC-I and JACE, anterior fibres of the MCL were preserved, 10 , 11 and for the Kudo type-5 elbow, the MCL was transected as a routine procedure. 9 , 16 , 17 After cutting the bone and removal of the damaged trochlea and ulnar surface using a guide instrument, both humeral and ulnar components were cement fixed for SKC-I and JACE.…”

Section: Methodsmentioning

confidence: 99%

“… 8 , 9 We have previously reported favourable mid- to long-term clinical results of alumina ceramic unlinked TEA for patients with RA. 10 , 11 To date, few papers have examined the results of unlinked TEA in young RA patients. The current study aimed to investigate the clinical and radiological outcomes of unlinked TEA in Japanese patients with RA who are less than 50 years, with a minimum follow-up of six years.…”

Section: Introductionmentioning

confidence: 99%

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Outcome of unlinked total elbow arthroplasty for rheumatoid arthritis in patients younger than 50 years old

et al. 2023

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Aims There are concerns regarding complications and longevity of total elbow arthroplasty (TEA) in young patients, and the few previous publications are mainly limited to reports on linked elbow devices. We investigated the clinical outcome of unlinked TEA for patients aged less than 50 years with rheumatoid arthritis (RA). Methods We retrospectively reviewed the records of 26 elbows of 21 patients with RA who were aged less than 50 years who underwent primary TEA with an unlinked elbow prosthesis. The mean patient age was 46 years (35 to 49), and the mean follow-up period was 13.6 years (6 to 27). Outcome measures included pain, range of motion, Mayo Elbow Performance Score (MEPS), radiological evaluation for radiolucent line and loosening, complications, and revision surgery with or without implant removal. Results The mean MEPS significantly improved from 47 (15 to 70) points preoperatively to 95 (70 to 100) points at final follow-up (p < 0.001). Complications were noted in six elbows (23%) in six patients, and of these, four with an ulnar neuropathy and one elbow with postoperative traumatic fracture required additional surgeries. There was no revision with implant removal, and there was no radiological evidence of loosening around the components. With any revision surgery as the endpoint, the survival rates up to 25 years were 78.1% (95% confidence interval 52.8 to 90.6) as determined by Kaplan-Meier analysis. Conclusion The clinical outcome of primary unlinked TEA for young patients with RA was satisfactory and comparable with that for elderly patients. A favourable survival rate without implant removal might support the use of unlinked devices for young patients with this disease entity, with a caution of a relatively high complication rate regarding ulnar neuropathy. Level of Evidence: Therapeutic Level IV Cite this article: Bone Jt Open 2023;4(1):19–26.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcome of unlinked total elbow arthroplasty for rheumatoid arthritis in patients younger than 50 years old

et al. 2023

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“…Of the 8 articles reporting survival analysis with confidence intervals, only 1 reported PROMs in enough detail to be included in the meta-analysis (19). Of the remainder of articles reporting survival without CIs, a further 3 reported pre-and postoperative PROMs with standard deviation or confidence intervals (23)(24)(25). All studies used the Mayo Elbow Performance Score (MEPS).…”

Section: Patient-reported Outcome Measuresmentioning

confidence: 99%

How long does an elbow replacement last? A systematic review and meta-analysis of case-series and national registry reports with more than 10 years of follow-up

Evans

Mohammad

et al. 2022

ActaO

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Background and purpose: This study aims to determine, for the first time, generalizable data on the longevity and long-term function of elbow replacements.Methods: In this systematic review and meta-analysis, we searched MEDLINE and Embase for articles reporting 10-year or greater survival of total elbow replacements (TERs) and distal humeral hemiarthroplasty. Implant survival and patient reported outcome measures (PROMs) data were extracted. National joint replacement registries were also analyzed. We weighted each series and calculated a pooled survival estimate at 10, 15, and 20 years. For PROMs we pooled the standardized mean difference (SMD) at 10 years.Findings: Despite its widespread use, we identified only 9 series reporting all-cause survival of 628 linked TERs and 610 unlinked TERs and no series for distal humeral hemiarthroplasty. The studied population was treated for rheumatoid arthritis in over 90% of cases. The estimated 10-year survival for linked TERs was 92% (95% CI 90–95) and unlinked TERs 84% (CI 81–88). 2 independent registries contributed 32 linked TERs and 530 unlinked TERs. The pooled registry 10-year survival for unlinked TERs was 86% (CI 83–89). Pooled 10-year PROMs from 164 TERs (33 linked and 131 unlinked), revealed a substantial improvement from baseline scores (SMD 2.7 [CI 1.6–3.8]).Interpretation: Over 80% of all elbow replacements and over 90% of linked elbow replacements can last more than 10 years with sustained patient-reported benefits. This information is long overdue and will be particularly useful to patients as well as healthcare providers.

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Mid-term results of alumina ceramic unlinked total elbow arthroplasty with cement fixation for patients with rheumatoid arthritis

Abstract: With the appropriate indications, the mid-term clinical performance of the cemented JACE TEA is reliable and comparable to other established TEAs in the management of the elbow in patients with RA. Cite this article: Bone Joint J 2018;100-B:1066-73.

Cited by 13 publications

References 49 publications

Outcome of unlinked total elbow arthroplasty for rheumatoid arthritis in patients younger than 50 years old

Outcome of unlinked total elbow arthroplasty for rheumatoid arthritis in patients younger than 50 years old

How long does an elbow replacement last? A systematic review and meta-analysis of case-series and national registry reports with more than 10 years of follow-up

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