Long-term survival of the Souter-Strathclyde total elbow replacement in patients with rheumatoid arthritis

Ikävalko, Mikko; Tiihonen, R.; Skyttä, Eerik; Belt, Eero A.

doi:10.1302/0301-620x.92b5.22613

Cited by 29 publications

(34 citation statements)

References 13 publications

(6 reference statements)

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“…[1][2][3][4][5][6] Treatment includes the use of long-term antibiotics, 7 early extensive irrigation and debridement, 8 resection arthroplasty 9,10 or revision arthroplasty in either one or two stages. 8,11 The use of suppressive antibiotic therapy has been shown to be of value primarily when infection occurs in the immediate post-operative period.…”

mentioning

confidence: 99%

Two-stage revision for the treatment of the infected total elbow arthroplasty

Peach

Nicoletti

Lawrence

et al. 2013

The Bone & Joint Journal

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We report our experience of staged revision surgery for the treatment of infected total elbow arthroplasty (TEA). Between 1998 and 2010 a consecutive series of 33 patients (34 TEAs) underwent a first-stage procedure with the intention to proceed to second-stage procedure when the infection had been controlled. A single first-stage procedure with removal of the components and cement was undertaken for 29 TEAs (85%), followed by the insertion of antibiotic-impregnated cement beads, and five (15%) required two or more first-stage procedures. The most common organism isolated was coagulase-negative Staphylococcus in 21 TEAs (62%). A second-stage procedure was performed for 26 TEAs (76%); seven patients (seven TEAs, 21%) had a functional resection arthroplasty with antibiotic beads in situ and had no further surgery, one had a persistent discharge preventing further surgery. There were three recurrent infections (11.5%) in those patients who underwent a second-stage procedure. The infection presented at a mean of eight months (5 to 10) post-operatively. The mean Mayo Elbow Performance Score (MEPS) in those who underwent a second stage revision without recurrent infection was 81.1 (65 to 95). Staged revision surgery is successful in the treatment of patients with an infected TEA and is associated with a low rate of recurrent infection. However, when infection does occur, this study would suggest that it becomes apparent within ten months of the second stage procedure.

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confidence: 99%

Two-stage revision for the treatment of the infected total elbow arthroplasty

Peach

Nicoletti

Lawrence

et al. 2013

The Bone & Joint Journal

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“…Among the patients with nerve lesions (4/46), two presented neuropraxia (one of the ulnar nerve and one of the radial nerve). Complete tears occurred in two patients, in the median arthritis (6,11,12) . In mixed series, there has generally been a large predominance of rheumatoid arthritis cases (9) , but our series different in this respect (54.35% with sequelae of trauma and 32.61% with rheumatoid arthritis).…”

Section: Resultsmentioning

confidence: 98%

Resultados da artroplastia total do cotovelo Bi-Contact®: estudo multicêntrico

Benegas¹,

Malavolta

Gracitelli³

et al. 2011

Rev. bras. ortop.

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Objective: To describe the initial experience of four orthopedic clinics from using Bi-Contact ® total elbow arthroplasty (TEA), reporting the results and complications of the procedure. Methods: This was a retrospective study, through analysis on the medical records of patients who underwent primary TEA using a prosthesis model developed in conjunction with IOT-HCFMuSP. Forty-six elbows (45 patients) that were operated at four orthopedic clinics between 2000 and 2009 were evaluated. Results: The majority of the patients were female (74%), and the median age was 62.5 years. The diagnoses encountered were trauma sequelae (47.83%), rheumatoid arthritis (32.61%), primary osteoarthrosis (8.7%), acute fractures (6.52%) and heterotopic ossification (2.17%). The median length of follow-up was 2.08 years (0.25-9). The procedure significantly alleviated pain and improved range of motion. It was observed that at least one complication was present in 69.57% of the cases, and the main ones were infection (28.26%), need for revision (28.26%), intraoperative fracture (15.22%) and aseptic loosening (15.22%). Conclusion: Bi-Contact ® TEA provided significant alleviation of pain and improvement of range of motion in the present series. The complication rate was high, and the most frequently observed complications were infection, aseptic loosening and intraoperative fracture.

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“…9 Instability of this implant has been less frequent than that of other unlinked designs; however, loosening of the shortstemmed humeral component has a 3.6-to 5.6-fold risk of revision for aseptic loosening compared to the longstemmed humeral components. 10 The Kudo total elbow arthroplasty was introduced in 1972. 11,12 Initially, both the Type 1 and Type 2 prostheses had non-stemmed humeral components with a cylindrical articulation; however, the humeral component was redesigned to a stemmed component because of a high incidence of early loosening.…”

Section: Historymentioning

confidence: 99%

The History and Future of Unlinked Total Elbow Arthroplasty

et al. 2017

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Unlinked total elbow arthroplasty (TEA), which has no mechanical connection between the humeral and ulnar components, has theoretical advantages based on its near-normal elbow kinematics and the preservation of bone stock. Unlinked TEA is appropriate only for patients who have limited bone loss or limited deformity and good ligamentous function. This is because postoperative instability has been a major complication of unlinked prostheses. The concept and goal of unlinked TEA is to share the loading stress on the bone implant interface with the surrounding tissues. Although the loosening rate of unlinked prostheses theoretically should be lower than that of linked prostheses (which have a mechanical connection between the humeral and ulnar components), there is no clear evidence that unlinked TEAs are superior to linked TEAs in this respect. However, we believe that primary TEA should be performed using an unlinked TEA, especially for younger patients, because revision surgery for unlinked TEA results in longer prosthesis survival than revision surgery for linked TEA. Improvement of the design of unlinked prostheses and the introduction of less invasive surgical techniques are required to reduce postoperative instability.

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Long-term survival of the Souter-Strathclyde total elbow replacement in patients with rheumatoid arthritis

Cited by 29 publications

References 13 publications

Two-stage revision for the treatment of the infected total elbow arthroplasty

Two-stage revision for the treatment of the infected total elbow arthroplasty

Resultados da artroplastia total do cotovelo Bi-Contact®: estudo multicêntrico

The History and Future of Unlinked Total Elbow Arthroplasty

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