Long-term outcomes of total elbow arthroplasty: a systematic review of studies at 10-year follow-up

Davey, Martin S.; Hurley, Eoghan T.; Gaafar, Mohamed; Molony, Diarmuid C.; Mullett, Hannan; Pauzenberger, Leo

doi:10.1016/j.jse.2020.11.014

Cited by 27 publications

(19 citation statements)

References 46 publications

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“…These findings were also supported by Davey et al in their long-term outcomes systemic review. [16] The current study shows that patients following TEA demonstrate an advantage in flexion compared with patients following ORIF of the distal humerus. However, there was no statistically significant difference in grip strength between the patients who were treated by TEA or ORIF.…”

Section: Discussionmentioning

confidence: 52%

“…[14,15] In a systemic review, Davey et al aimed to evaluate the functional outcomes, dislocation, and revision rates following TEA at a minimum 10-year mean follow-up. [16] Overall, 1276 patients following TEA from 23 studies were enrolled in their systematic review. Of these, 1060 patients had undergone TEA due to rheumatoid arthritis and 257 patients had undergone TEA due to other indications, including trauma.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Total Elbow Arthroplasty in Trauma Patients Compared with Patients Following Fixation of Distal Humerus Fractures

Maman¹,

Weishahe²,

Norman³

et al. 2022

Preprint

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Background and purpose: Total elbow arthroplasties (TEA) aim to replicate anatomy and provide stability in the treatment of distal fractures of the humerus. In the presence of an aging population with higher functional demand, improving patients’ well-being is crucial. This study aimed to analyze patients’ reported outcomes and functional outcomes for TEA in comminuted fractures of the distal humerus and to compare these outcomes with their counterpart patients who have been treated with open reduction and internal fixation (ORIF). In addition, this study aims to compare the secondary procedures rate between the two groups.Patients and Methods: Eligible patients were those who underwent TEA or ORIF of the distal humerus and completed several patient-reported outcome (PRO) questionnaires including the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, 12-Item Short Form Health Survey Physical and Mental components (SF-12 P and SF-12 M, respectively) scores, visual analog scale (VAS) score for pain, and patient satisfaction ratings (1-5). A physical examination including range of motion, instability, and strength was performed for all patients. Results: This study found that patients following TEA have shown significantly lower pain levels (TEA: 3.72±2.8; ORIF 5.2±2.98, P=0.019) and higher satisfaction levels (TEA: 4.18±1.17; ORIF 3.57±1.46, P=0.035) compared with patients following ORIF. DASH score (TEA: 33.7±29.4; ORIF 39.75±24.6, P=0.31) and SF-12 score (TEA: 31.7±9.67; ORIF 31.25±10.2, P=0.85) were not statistically different between TEA and ORIF.Patients following TEA have demonstrated an advantage in flexion compared with patients following ORIF (P=0.045). Both patients following TEA and ORIF demonstrated no statistically significant difference in pronation and supination of the operated elbow compared to the contralateral side. Although, a decreased range in extension and flexion of the operated elbow compared with the contralateral side was demonstrated in both groups (extension P=0.005, flexion P<0.001). The grip Test showed no significant difference between the patients who were treated by TEA or ORIF (P=0.99). Moreover, ORIF in comminuted fractures of the distal humerus in elders may be associated with a higher complication rate compared with TEA.Conclusion: TEA following comminuted fractures of the distal humerus is associated with favorable satisfaction, pain levels, and range of motion in flexion compared with patients following ORIF of the distal humerus. Additionally, TEA may be associated with a lower rate of secondary procedures.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Outcomes of Total Elbow Arthroplasty in Trauma Patients Compared with Patients Following Fixation of Distal Humerus Fractures

Maman¹,

Weishahe²,

Norman³

et al. 2022

Preprint

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“…4 , 29 , 30 One systematic review showed that the incidence of nerve injury is significantly (p = 0.09) lower in unlinked devices (4/474, 0.8%) than in linked devices (24/762, 3.2%). 3 Our incidence of ulnar nerve neuropathy is much higher than ever reported, however it is unclear why ulnar neuropathy is more likely to occur after TEA in younger patients.…”

Section: Discussionmentioning

confidence: 70%

“…Recent systematic reviews showed satisfactory clinical outcomes of TEA at long-term follow-up after a minimum ten years' mean follow-up, 3 and the weighted mean survival rate of TEA implants in RA patients was 72.6% after 12.9 years. 4 However, the reported complication and revision rates after TEA in RA range from 5.2% to 30.9% and 11% to 13%, respectively.…”

Section: Introductionmentioning

confidence: 99%

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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“…Total joint replacement at the elbow is not commonly performed, usually reserved for patients with chronic pain and/or limited range of motion related to severe elbow joint osteoarthritis or joint destruction due to acute or chronic inflammatory arthritis. 30 On follow-up imaging, assessment for complications is similar to joint replacements in other areas of the body, looking for periprosthetic lucency and migration of the implant or subsidence in which case the implant progressively sinks into the bone. Infection is suggested by lucency around the implant, soft tissue swelling, and periosteal reaction (►Fig.…”

Section: Arthroplastymentioning

confidence: 99%

Imaging the Postoperative Elbow

Deely

Morrison

2021

Semin Musculoskelet Radiol

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Evaluation of postoperative images of any joint can be a daunting task, and the elbow is no exception. Patients may be imaged with a complication of the repair, or the postoperative changes may be incidentally observed as the patient is imaged for other reasons. We divide the postoperative elbow into soft tissue procedures (covering ligament and tendon repairs, as well as compartmental release and nerve transposition), joint-related procedures (osteochondral lesion treatment, ostectomy, and joint replacement), and bone procedures (fracture fixation). We summarize the procedures and their indications, show normal imaging appearances, and finally cover common complications.

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Long-term outcomes of total elbow arthroplasty: a systematic review of studies at 10-year follow-up

Cited by 27 publications

References 46 publications

Outcomes of Total Elbow Arthroplasty in Trauma Patients Compared with Patients Following Fixation of Distal Humerus Fractures

Outcomes of Total Elbow Arthroplasty in Trauma Patients Compared with Patients Following Fixation of Distal Humerus Fractures

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

Imaging the Postoperative Elbow

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