The Lateral Para-Olecranon Approach for Total Elbow Arthroplasty

Studer, Alexis; Athwal, George S.; MacDermid, Joy C.; Faber, Kenneth J.; King, Graham J.W.

doi:10.1016/j.jhsa.2013.07.029

Cited by 75 publications

(43 citation statements)

References 20 publications

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“…The morphology of the injury may affect clinical presentation, imaging analysis, and surgical strategies. Furthermore, complications with triceps healing after total elbow arthroplasty have generated renewed interest in the adoption of “triceps-on” exposures and lateral and medial paraolecranon approaches that respect portions of the triceps insertion 1, 5, 16, 17…”

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confidence: 99%

The distal triceps tendon insertional anatomy—implications for surgery

et al. 2017

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BackgroundImproved knowledge of the distal triceps insertion is needed as a result of an increase in procedures involving this area, including distal triceps repair, posterior capsulectomy, and olecranon tip osteotomy for coronoid reconstruction.Materials and methodsFive pair-matched upper limbs were dissected to study the morphology and dimension of the distal triceps tendon, triceps tendon insertion, capsular insertion on the olecranon, and triceps lateral retinaculum. Muscle origins of the triceps insertions were identified proximally.ResultsThree distinct insertional areas were found in the olecranon corresponding to the posterior capsular insertion, the deep muscular portion, and the superficial tendinous portion of the triceps with areas of 1.5, 1.2, and 2.8 cm2, respectively. The deep muscular head corresponded to the medial head of the triceps and the tendinous portion corresponded to the long and lateral heads and correlated with the height of the specimen. The triceps width at insertion was 2.6 ± 0.5 cm (standard deviation), and the triceps lateral retinaculum extended the tendon laterally for 2.5 ± 0.7 cm. The tendinous portion of the triceps tendon extended proximally 15.3 ± 1.4 cm. The triceps inserted at a mean of 1.1 cm from the tip of the olecranon.ConclusionsThe distinct insertional heads of the triceps provides additional knowledge that can aid in diagnosing and treating partial triceps tears. In addition, a safe zone for capsulectomy and olecranon tip osteotomy is described that can be used to increase the safety of these procedures.

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confidence: 99%

The distal triceps tendon insertional anatomy—implications for surgery

et al. 2017

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“…With a total of 82 patients, the triceps on group had a significantly better range of movement than triceps off. For rheumatoid arthritis, another study 22 showed that a triceps splitting approach has a significantly greater flexion contracture, although the flexion range remained similar, in comparison to two triceps on approaches, 19,22 whereas the flexion range remained similar.…”

Section: Range Of Movementmentioning

confidence: 98%

Triceps on approach for total elbow arthroplasty: worth preserving? A review of approaches for total elbow arthroplasty

Booker

Smith

2016

Shoulder & Elbow

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“…A distally based triceps flap is commonly used, but recently we have tried to preserve the insertion of the triceps tendon into the olecranon by using the triceps-on approach. 21,22 Then, the medial collateral ligament is divided and the elbow is dislocated. The radial head is excised, but the lateral collateral ligament is preserved.…”

Section: Surgical Techniquesmentioning

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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The Lateral Para-Olecranon Approach for Total Elbow Arthroplasty

Cited by 75 publications

References 20 publications

The distal triceps tendon insertional anatomy—implications for surgery

The distal triceps tendon insertional anatomy—implications for surgery

Triceps on approach for total elbow arthroplasty: worth preserving? A review of approaches for total elbow arthroplasty

The History and Future of Unlinked Total Elbow Arthroplasty

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