Linked semiconstrained and unlinked total elbow replacement in juvenile idiopathic arthritis: a case comparison series with mean 11.7-year follow-up

2017 ◽  
Vol 26 (2) ◽  
pp. 305-313 ◽  
Author(s):  
Edward F. Ibrahim ◽  
Abbas Rashid ◽  
Michael Thomas
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Total Elbow Replacement ◽  
Case Comparison ◽  
Elbow Replacement ◽  
Comparison Series

scholarly journals The use of Tranexamic Acid in Total Elbow Replacement to Reduce Post-Operative Wound Infection

2018 ◽  
Vol 3 (2) ◽  
pp. 104-107 ◽  
Author(s):  
Syed Mannan ◽  
Mohammed Ali ◽  
Lukasz Mazur ◽  
Mei Chin ◽  
Ahmed Fadulelmola
Keyword(s):  
Wound Healing ◽  
Tranexamic Acid ◽  
Case Series ◽  
Wound Complications ◽  
Reduce Blood Loss ◽  
Total Elbow Replacement ◽  
Elbow Fractures ◽  
The Mean ◽  
Elbow Replacement

Abstract. Background: Incidence of infection following total elbow replacement (TER) is recognised to be higher compared to hip or knee arthroplasty. Extensive swelling following TER can complicate the wound healing which might lead to infection. Tranexamic Acid (TXA) is proven to reduce blood loss peri-operatively which might contribute to better healing outcomes. Our aim is to assess the effect of TXA in wound healing following TER.Methods: A retrospective review of a single surgeon case series. 10 patients had TER mainly for complicated elbow fractures, four of them were relatively immune-supressed. All patients had 2 grams of TXA and antibiotics intra-operatively. All were reviewed at two weeks following surgery for wound check and removal of surgical clips.Results: Seven females and three males with a mean age of 81.5 had TER and TXA. The mean level of pre-operative haemoglobin was 134.40 g/l and the mean post-operative level was 122.70g/l. No patient in this series required blood transfusion. At two weeks and six weeks follow-up, all wound healed up with no signs of infection.Conclusion: TXA has been proven to be safe an effective way of reducing peri-operative bleeding. TXA maintains haemostasis after releasing the tourniquet and therefore reduces the swelling and wound complications post-operatively

scholarly journals Revision Total Elbow Replacement Arthroplasty with an Allograft-Prosthesis Composite: Case Series and Technical Points

2020 ◽  
Vol 25 (2) ◽  
pp. 101-107
Author(s):  
Young Ju Chae ◽  
Hyun Sik Gong
Keyword(s):  
Range Of Motion ◽  
Case Series ◽  
Bone Union ◽  
Radial Nerve Palsy ◽  
Total Elbow Replacement ◽  
Replacement Arthroplasty ◽  
The Mean ◽  
Elbow Replacement ◽  
Joint Range

Purpose: The purpose of this study was to report the results of revision total elbow replacement arthroplasty (TERA) with an allograft-prosthesis composite (APC). Methods: We retrospectively reviewed 6 patients with an average age of 75 years who had undergone revision TERA with an APC for periprosthetic fracture or loosening of the component. The mean follow-up period was 13 months. We assessed serial radiographs for bone union and evaluated the outcomes in terms of pain visual analogue scale (VAS), the Mayo Elbow Performance Score (MEPS), range of motion, and complications. Results: The APC was used for the humerus in 5 patients and for the ulna in 1 patient. The clinical bone union was achieved at average 9 months after surgery. The mean pain VAS score improved from 6.8 to 1.7, the mean elbow joint range of motion increased from 95° to 129° and the MEPS score improved from 40 to 79 at the last follow-up. There were no major complications such as infection, nonunion, malunion, limitation of motion or refracture. One patient experienced transient radial nerve palsy and another patient a prominent edge of the humeral allobone that needed a trimming surgery later.Conclusion: Revision TERA with an APC provides good functional outcomes and can be recommended as one of the options for failed total elbow arthroplasty.

scholarly journals Shoulder and Elbow Surgery in Juvenile Idiopathic Arthritis

2020 ◽  
Vol 14 (1) ◽  
pp. 82-87
Author(s):  
Mark P. Figgie ◽  
Barbara Kahn ◽  
Evan A O’Donnell
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Growth Plate ◽  
Surgical Management ◽  
Functional Improvement ◽  
Surgical Approaches ◽  
Joint Involvement ◽  
Shoulder Replacement ◽  
Early Loosening ◽  
Total Elbow Replacement ◽  
Elbow Replacement

Juvenile idiopathic arthritis (JIA) is a chronic inflammatory arthropathy that manifests itself prior to the age of sixteen years with symptoms lasting six weeks or longer. As JIA frequently effects the upper extremities, activities of daily living become compromised during the stages of development when young adults are striving for independence. Symptomatology includes ankylosing, pain and early growth plate closure. Patients with joint involvement prior to growth plate closure have the most destruction in terms of joint abnormality and surgical complexity.Medical management of JIA has allowed for better non-surgical management, yet, there is a continued need to understand the appropriate surgical intervention and order for the greatest functional gains. Comparative studies have shown that varied results as to whether the shoulder replacement should supersede the elbow replacement or should that be reversed or both joint replacements done simultaneously. Our experience found a more significant functional improvement after total elbow replacement due to the unpredictable nature from the shoulder replacement outcomes and an inability for patients to do simple tasks such as bringing a cup to their mouths or handling a toothbrush. The exception to this occurs if the ipsilateral shoulder joint is severely limited to the point that the stressors placed on the elbow due to compensation will lead to early loosening or failure of the elbow joint replacement.Various methods for performing joint replacement of the shoulder and elbow in the JIA population will be discussed. Soft tissue integrity including the functional status of the rotator cuff will be a consideration for which surgical procedure should be considered. Surgical approaches for the elbow present fewer options for improving pain and function in this patient population. Pre, peri and postoperative management is reviewed as careful attention to irregular bony dimensions and dysmorphic anatomy precludes the use of standard implants.Total shoulder and total elbow arthroplasty should be considered in the JIA population where pain and significant functional compromise are present. The order of procedures is dependent on multiple factors and expected outcomes. Educating patients on postoperative expectations over the lifespan is an important part of surgical management for patients with JIA.

Complications and Revision Rate as the Type of Prosthesis of Total Elbow Replacement: Long-term Follow-up in Korea

2010 ◽  
Vol 45 (1) ◽  
pp. 10 ◽  
Author(s):  
Jung-Man Kim ◽  
Sang-Myung Lee ◽  
Jae-Chul Park ◽  
Seok-Whan Song ◽  
Yang-Guk Jung ◽  
...  
Keyword(s):  
Revision Rate ◽  
Total Elbow Replacement ◽  
Long Term Follow Up ◽  
Elbow Replacement

scholarly journals Total elbow replacement with the Coonrad-Morrey prosthesis: our medium to long-term results

2012 ◽  
Vol 94 (3) ◽  
pp. 189-192 ◽  
Author(s):  
R Maheshwari ◽  
S Vaziri ◽  
RH Helm
Keyword(s):  
Rheumatoid Arthritis ◽  
The Other ◽  
Long Term Results ◽  
X Rays ◽  
Total Elbow Replacement ◽  
Ulnar Nerve Palsy ◽  
The Mean ◽  
Elbow Replacement

INTRODUCTION Semiconstrained total elbow replacement is now a well recognised and reliable surgical option for advanced elbow disease, mainly rheumatoid arthritis. METHODS We report a retrospective analysis of 31 primary total elbow replacements in 28 patients with a mean follow-up duration of 55 months. The mean age of the patients was 65 years. The indications included 27 cases of rheumatoid arthritis, 3 fractures and 1 case of osteoarthritis. Twenty-one elbows in nineteen patients were assessed using the Mayo elbow performance score (MEPS) in a special follow-up clinic. In the other nine patients (ten elbows), the assessment was carried out with case notes and x-rays. RESULTS The mean pre-operative MEPS in the 21 elbows recalled was 40. This improved to 89 post-operatively (range: 55-100). Sixteen of the twenty-one elbows were considered excellent, two good, two fair and one poor. The range of movement was recorded in eight of the other ten elbows and the mean was 98°. At the last follow-up visit, x-rays were normal in 23 elbows although the ulnar component was loose in 3, the humeral component loose in 2. There were also two cases of nonunion of the medial epicondyle and one patient had mild heterotopic ossification. Complications included one infection, which needed irrigation and debridement with a satisfactory final result, and two cases of ulnar nerve palsy/neurapraxia. Two elbows were considered failures due to severe pain caused by prosthetic loosening. These were referred for revision surgery. CONCLUSIONS Excellent pain relief and good function can be achieved in the medium and long term with the Coonrad-Morrey semiconstrained total elbow replacement prosthesis in patients with severe destructive elbow arthropathy.

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