Prospective cohort study comparing a triceps-sparing and triceps-detaching approach in total elbow arthroplasty: a protocol

Abstract

BackgroundNew surgical approaches have been developed to optimise elbow function after total elbow arthroplasty (TEA). Currently, there is no consensus on the best surgical approach. This study aims to investigate the functional outcomes, prosthetic component position and complication rates after a triceps-sparing and a triceps-detaching approach in TEA.Methods and analysisA multicentre prospective comparative cohort study will be conducted. All patients with an indication for primary TEA will enrol in either the triceps-sparing or the triceps-detaching cohort. Primary outcome measure is elbow function, specified as fixed flexion deformity. Secondary outcome parameters are self-reported and objectively measured physical functioning, including triceps force, prosthetic component position in standard radiographs and complications.DiscussionThe successful completion of this study will clarify which surgical approach yields better functional outcomes, better prosthetic component position and lower complication rates in patients with a TEA.Ethics and disseminationThe Medical Ethics Review Board of University Medical Center Groningen reviewed the study and concluded that it is not clinical research with human subjects as meant in the Medical Research Involving Human Subjects Act (WMO), therefore WMO approval is not needed (METc2019/544).Trial registration numberNTR NL8488.

Triceps Sparing Approach for Fixation of Distal Humerus Fractures in Adults

“…Most recently and reflecting the important of the current work, Meijering et al [15] registered a large trial to establish a consensus on the ideal approach for total elbow arthroplasty [triceps sparing vs. triceps detaching]. They suggested that, no consensus is present on the best surgical approach.…”

“…Radiological outcome revealed that, union achieved in all patients. The mean time of bone union was 14.8 ± 0.72 weeks [12][13][14][15][16][17][18][19][20]. There were no non-union.…”

“…In the current study, ORIF was applied for 33 patients with distal humerus fractures through triceps-sparing approach. The mean elbow flexion was 140.45±3.82 degrees [135-145], and the mean elbow extension was 9.96±2.98 degrees [6][7][8][9][10][11][12][13][14][15]. Radiological outcome was achieved in all patients.…”