Primary total elbow arthroplasty

Badre, Armin; King, Graham J.W.

doi:10.1016/j.jcot.2021.04.015

Cited by 4 publications

(5 citation statements)

References 38 publications

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“…Inicialmente idealizada para pacientes idosos, portadores de doen ças reumatológicas e de baixa demanda (carga isolada ≈ 5kg ou cíclica ≈ 2,5 kg), a ATC passou a ser utilizada em pacientes cada vez mais jovens, em casos de fratura aguda com grandes perdas ósseas e/ou sequelas pós-traumáticas e de moderada (94% dos pacientes)/alta demanda (40% dos pacientes) 1 . Consequentemente, aumentou-se o risco de falha mecânica e diminuiu-se a sobrevida da prótese nos denominados pacientes de alta demanda: homens, casos pós-fratura/pseudoartrose, jovens, obesos e portadores de deformidade e/ou anquilose pré-operatória 1,6,10…”

Section: Discussionunclassified

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Artroplastia total no tratamento da sequela pós-traumática do cotovelo

Farias,

Castro,

Tanaka

et al. 2024

RTO

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A artroplastia total do cotovelo foi criada em meados de 1970 para tratamento da doença reumatoide avançada. Com o melhor desenvolvimento da técnica cirúrgica e dos implantes outras indicações surgiram: fraturas agudas do úmero distal em idosos, sequelas pós traumáticas, instabilidade disfuncional, reconstrução tumoral e osteoartrose primária. Todavia, são crescentes os casos de complicações e as taxas de revisões cirúrgicas. Os desafios atuais da artroplastia do cotovelo são: as perdas ósseas que exigem construções de revisão melhoradas e o manejo em pacientes jovens de alta demanda que tendem a evoluir com desfechos menos favoráveis. Apresentaremos um relato de caso de um paciente feminino, 42 anos, com sequela de fratura do úmero distal direito há 7 anos que foi tratada com artroplastia total do cotovelo

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Section: Discussionunclassified

“…A artroplastia total do cotovelo surgiu em meados de 1970 como procedimento restrito às doenças reumáticas avançadas 1,2 . É raramente realizada quando comparada à artroplastia de joelho e quadril, sendo preconizado sua abordagem por cirurgiões experientes em centros de referência 3 .…”

Section: Introductionunclassified

Artroplastia total no tratamento da sequela pós-traumática do cotovelo

Farias,

Castro,

Tanaka

et al. 2024

RTO

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“…All patients in this study received the semi‐constrained prostheses. Immediate stability from the linkage mechanism can be obtained in this prosthesis and can be applied even with ligamentous insufficiency or extensive bone loss 27 . Furthermore, in the case of elbow stiffness or deformity, this design allows for more extensive release without increasing the risk of elbow instability.…”

Section: Discussionmentioning

confidence: 99%

“…Each approach provides variation in the amount of exposure, technical difficulty, and complication profile 18,53,54 . The approaches described for TEA fall into two major categories: triceps off, in which the triceps is detached from the olecranon, and triceps on or triceps‐preserving, in which most of the triceps insertion on the olecranon is kept intact 27 …”

Section: Discussionmentioning

confidence: 99%

“…Immediate stability from the linkage mechanism can be obtained in this prosthesis and can be applied even with ligamentous insufficiency or extensive bone loss. 27 Furthermore, in the case of elbow stiffness or deformity, this design allows for more extensive release without increasing the risk of elbow instability. Some studies have reported the 10‐year survivorship data of TEA in which the 10‐year survivorship for general indications was 91% and 85%–92% for rheumatoid arthritis, 89% for acute distal humerus fracture, 89% for osteoarthritis, 69%–80% for juvenile inflammatory arthropathy, and 42% for hemophilia.…”

Section: Discussionmentioning

confidence: 99%

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Clinical and Radiographic Outcomes of Total Elbow Arthroplasty Using a Semi‐constrained Prosthesis with a Triceps‐preserving Approach over a Minimum Follow‐up Period of 4 Years

Zhang¹,

Xiang²,

Yang³

et al. 2023

Orthopaedic Surgery

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ObjectiveComplications related to triceps after total elbow arthroplasty (TEA) have become a major surgical concern. The triceps‐preserving approach has the advantage of not disturbing the insertion of triceps but is disadvantaged by the reduced exposure of the elbow joint. The aim of this study was to investigate the clinical and radiological outcomes of TEA with a triceps‐preserving approach and to compare the outcomes of TEA to treat arthropathy with that of TEA to treat acute distal humerus fracture.MethodsFrom January 2010 to December 2018, 23 patients undergoing primary TEAs were retrospectively reviewed with a mean follow‐up time of 92.6 months (range, 52–136 months). Each TEA was performed using the triceps‐preserving approach with a semi‐constrained Coonrad–Morrey prosthesis. Patient demographics, range of motion (ROM), pain visual analogue scale (VAS), and triceps strength (Medical Research Council [MRC] scale) were compared before and after surgery. The Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiographic outcome, and complications were evaluated at follow‐up.ResultsIn total, seven males and 16 females were included in this study, with a mean age of 66.1 years (range:46–85 years). By the last follow‐up, pain had been significantly relieved in all patients. The average MEPS in the arthropathy group and fracture group were 90.8 ± 10.3 points (range: 68–98 points) and 91.7 ± 0.4 (range: 76–100 points), respectively. The average DASH of the arthropathy group and fracture group was 37.3 ± 18.8 points (range: 18–52 points) and 38.4 ± 20.1 (range: 16–60 points). At the last follow‐up after surgery, the mean flexion arcs in the arthropathy group and fracture group were 100.4° ± 24.1° and 97.8° ± 28.1°, respectively. The mean pro‐supination arcs in the arthropathy group and fracture group were 142.4° ± 15.2° and 139.2° ± 17.5°, respectively. There were no significant differences in clinical outcomes between the two groups (P ≥ 0.05). Triceps strength was normal (MRC grade V) in 15 elbows and good in eight elbows. None of the cases experienced weakness of the triceps strength, infection, periprosthetic fractures, or prosthesis breakage.ConclusionsThe clinical and radiographical outcomes of TEA with the triceps‐preserving approach were satisfactory in patients with distal humerus fracture, osteoarthritis and rheumatoid arthritis.

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Long-term outcomes and trends in elbow arthroplasty with Coonrad-Morrey prosthesis: a retrospective study in large group of patients

Tarallo,

Celli,

Delvecchio

et al. 2024

International Orthopaedics (SICOT)

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Purpose Total Elbow Arthroplasty (TEA) was first developed to treat severe rheumatoid arthritis, but its uses have grown to encompass end-stage osteoarthritis, post-traumatic arthritis, and distal humeral fractures. This study analyzes indications changes, long-term survival, complications, and post-operative functional results of the Coonrad-Morrey prostheses, enhancing the existing literature on this technique and substantial case history. Methods We included 122 arthroplasties in 117 patients, 28 males and 89 females (mean age of 67 years) treated in our hospital between 2002 and 2016. Minimum follow-up was four years. We collect functional parameters of 48 patients (51 elbows), due to death of patients due to old age and loss at follow-up. Results Survival rate at five years was 90%, 85% at 10 years and 83% at 15 years. The overall medium Mayo elbow score was 79.7 ± 18.3 with the highest result in osteoarthritis patients (p < 0.005); QuickDASH score was 33.1 ± 25.5 with the worse result in rheumatoid group. Average post-operative arc of motion (ROM) was 95°±27°. There were complications in 46 out of 122 cases (37.7%) and revision surgeries were performed in 12 of them (9.8%): seven aseptic loosening, four late septic loosening, one bushing wear. In 27 instances (22.1%) was reported ulnar nerve involvement. Conclusion Coonrad-Morrey prosthesis has shown satisfactory clinical results in the treatment of a wide range of pathologies. The long-term implant survivorship was satisfactory, yet the occurrence of failures and complications cannot be overlooked, above all the ulnar nerve paresthesia. There was a good recovery in quality of life, pain-free with limited residual limb disability.

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Primary total elbow arthroplasty

Cited by 4 publications

References 38 publications

Artroplastia total no tratamento da sequela pós-traumática do cotovelo

Artroplastia total no tratamento da sequela pós-traumática do cotovelo

Clinical and Radiographic Outcomes of Total Elbow Arthroplasty Using a Semi‐constrained Prosthesis with a Triceps‐preserving Approach over a Minimum Follow‐up Period of 4 Years

Long-term outcomes and trends in elbow arthroplasty with Coonrad-Morrey prosthesis: a retrospective study in large group of patients

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