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

Booker, Simon; Smith, Christopher D.

doi:10.1177/1758573216682479

Cited by 22 publications

(13 citation statements)

References 52 publications

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“…For an approach to be adequate it needs to be safe, reproducible, achieve adequate exposure to perform the intended procedure, and be minimally destructive to anatomical structures. 28 The two approaches presented in this study demonstrate no difference in positioning of the implants. With the hypothetical benefit of preservation of the extensor mechanism and earlier mobilisation using the triceps-on approach is a valid option from these results.…”

Section: Discussionmentioning

confidence: 64%

Does the triceps-on approach affect alignment in total elbow arthroplasty? A cadaveric study

et al. 2018

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Background The triceps-on approach for total elbow arthroplasty has gained popularity due to the theoretical benefit of preserving the extensor mechanism. However, there is concern that the exposure may be reduced in comparison to a triceps-off approach and may affect the implant alignment achieved. Method Total elbow arthroplasties were implanted in 18 randomised, paired cadaveric elbows using the triceps-on or triceps-off approach. The bones were dissected out and the position of the implants measured relative to anatomical landmarks. The flexion/extension and varus/valgus angles, and the distance of centre of rotation from the anatomic centre of rotation in the sagittal plane for both components were obtained as well as the humeral component rotation relative to the transepicondylar axis. Results All humeral components were positioned in external rotation and all ulna components were placed in flexion. Seven components were positioned greater than 5° away from the ideal in one measurement, with no significant difference between the two approach groups. Discussion This unique study showed no significant difference in the alignment of the implants between the two approaches. These results support the theory that the triceps-on approach does not result in larger alignment errors in component positioning when performing total elbow arthroplasty.

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Section: Discussionmentioning

confidence: 64%

Does the triceps-on approach affect alignment in total elbow arthroplasty? A cadaveric study

et al. 2018

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“…Better elbow extension strength has been reported in triceps on approaches compared to triceps off approaches. 29,30 Fig. 3.…”

Section: Surgical Approachesmentioning

confidence: 99%

Primary total elbow arthroplasty

Badre

King

2021

Journal of Clinical Orthopaedics and Trauma

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There have been significant improvements in surgical techniques and implant designs of elbow arthroplasty over the last five decades. These advances have resulted in improved outcomes and expansion of indications for total elow arthroplasty (TEA). As the proportion of TEAs being performed for inflammatory arthritis has been decreasing in recent years, TEAs are being performed more commonly for the management of acute distal humerus fractures in the elderly, post-traumatic sequelae, and primary osteoarthritis. Appropriate patient selection and meticulous attention to surgical technique including the surgical approach, implant positioning and fixation will result in acceptable outcomes. Future advances in the design, instrumentation, and surgical technique will allow for further improvement in outcomes as the indications for TEA continue to expand.

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“…The reason may be that triceps reflecting will minimize insult to soft tissue, which is already compromised by the index trauma. 22,23) We observed extension deficit (117° extension end point) in 1 study, in which triceps reflecting was solely used for repair. 11) Extension deficit may be associated with extensor mechanism weakness, which commonly results from inadequate repair, allowing the synovial fluid to be trapped between the triceps and its attachment.…”

Section: Discussionmentioning

confidence: 99%

Primary Linked Total Elbow Arthroplasty for Acute Distal Humerus Fracture Management: A Systematic Review of Clinical Outcome

Kholinne¹,

Altamimi

Aldayel

et al. 2020

Clin Orthop Surg

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Comminuted distal humerus fractures in the geriatric population are a challenging injury to treat. The principle of treatment of a displaced intra-articular distal humerus fracture is anatomical reduction of the joint surfaces with stable fixation of fracture fragments, hence promoting early mobilization. 1-3) Nevertheless, anatomical reduction and stable internal fixation are often unachievable due to severe comminution in osteoporotic bone particularly in the elderly population. The complication and loss of reduction rates are reported to be as high as 50% for comminuted distal humerus fractures after open reduction and internal fixation (ORIF). 4) With the improvement of prosthetic designs and surgical techniques, total elbow arthroplasty (TEA) is starting to gain recognition as a safe and effective alternative to ORIF. TEA has become an option to treat severely comminuted distal humerus fractures

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

Cited by 22 publications

References 52 publications

Does the triceps-on approach affect alignment in total elbow arthroplasty? A cadaveric study

Does the triceps-on approach affect alignment in total elbow arthroplasty? A cadaveric study

Primary total elbow arthroplasty

Primary Linked Total Elbow Arthroplasty for Acute Distal Humerus Fracture Management: A Systematic Review of Clinical Outcome

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