Functional outcomes and complications following convertible primary total elbow arthroplasty: A single surgeon series

P Value ◽

Performance Score ◽

Elbow Arthroplasty

Background The data on convertible total elbow arthroplasty are limited and primarily based on multiple centre/multiple surgeon series. The aim of this study was to report the mid-term functional outcomes, radiological findings, complications and survivorship of the Latitude total elbow arthroplasty performed by a single surgeon. Study design & methods The study included 13 patients (10 females, mean age of 72 years and varying indications) over eight years. The Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), range of movements (ROM), Subjective Elbow Value (SEV), satisfaction score (SS) and the revision rate of the implant per 100 observed component years (OCY) were assessed. Results The mean follow-up was 5.9 years (3–10 years). The Oxford Elbow Score/Mayo Elbow Performance Score improved from 15 to 42 ( p value < 0.005)/26% to 93% ( p value < 0.005) respectively. The arc of extension-flexion/supination-pronation improved from 63° to 106° ( p = 0.00002)/123° to 142° ( p = 0.32) respectively. The Subjective Elbow Value/Satisfaction Score was 83/98 respectively. There was one re-operation for a deep infection. There were no radiologic signs of loosening and the revision rate was 0.15 per 100 observed component years. Conclusions With careful patient selection, convertible total elbow arthroplasty provides patients with good to excellent outcomes and substantial improvements in the range of movements.

SEMI-CONSTRAINED TOTAL ELBOW ARTHROPLASTY IN CHINESE RHEUMATOID PATIENTS

Hand Surgery ◽

10.1142/s0218810403001649 ◽

2003 ◽

Vol 08 (02) ◽

pp. 187-192 ◽

Cited By ~ 8

Author(s):

C. Y. Lo ◽

K. B. Lee ◽

C. K. Wong ◽

Y. P. Chang

Keyword(s):

Bone Graft ◽

Deep Infection ◽

Radiological Sign ◽

Performance Score ◽

Early Complications ◽

Elbow Arthroplasty

Seventeen Coonrad-Morrey semi-constrained total elbow replacements were performed on 14 Chinese rheumatoid patients. The elbows were reviewed retrospectively after a mean follow-up of 36 months (range 12–89 months.) After the operation, all patients were satisfied and there was no pain in 15 elbows. There was no radiological sign of loosening in the implanted prostheses and bone graft was incorporated in 93% of primary elbow replacements. The Mayo Elbow Performance Score was improved from an average of 40 (range 20–75) to an average of 93 (range 65–100). The arc of flexion was improved from an average of 89° (range 0°–125°) to 104° (range 35°–125°). The sizes of implants can be predicted accurately by the planning template in only four elbows (24%) and there were early complications in seven elbows (41%), with one prosthesis removed because of deep infection.

A systematic review of the complications of contemporary total elbow arthroplasty

Shoulder & Elbow ◽

10.1177/1758573220905629 ◽

2020 ◽

pp. 175857322090562

Author(s):

Phoebe Parker ◽

Nicholas D Furness ◽

Jonathan P Evans ◽

Timothy Batten ◽

William J White ◽

...

Keyword(s):

Systematic Review ◽

Deep Infection ◽

Complication Rates ◽

Elbow Arthroplasty ◽

Specific Complication ◽

Inflammatory Arthropathy ◽

Cumulative Rate

Background Total elbow arthroplasty is a low volume procedure. We aimed to evaluate complication rates and cumulative percentages associated with the most frequently used contemporary implants and for the commonest indications. Methods A systematic literature search of all studies reporting complications following total elbow arthroplasty with 12-month minimum follow-up was undertaken. Quality of studies was assessed with the Methodological-Index-for-Non-Randomised-studies criteria. British NJR data identified the most common UK prostheses and indications. The complication rates for all undesirable events contributing to patient outcome were extracted and cumulative percentages were calculated. Results One hundred seventeen studies were screened, 12 studies included, totalling 815 procedures. Mean follow-up was 3.8 years. The overall complication cumulative percentage was 60.7%, significantly higher than that seen in other joint arthroplasty, including a 6.5% deep infection rate. Nerve injury was comparable between implants at around 4.1%. Radiographic loosening had a cumulative rate of 17.2%. Revision for symptomatic aseptic loosening was 6.3%. Conclusions This is the largest systematic review of the complications of total elbow arthroplasty. Surgeons should be aware of differing complications related to their implant of choice, each having its own specific complication. Trauma as an indication appears to have an increased complication rates compared to inflammatory arthropathy. There is a lack of literature regarding the independent results of osteoarthritis as a specific indication for total elbow arthroplasty.

Clinical outcomes and complications following primary total elbow arthroplasty using the Latitude prosthesis

Shoulder & Elbow ◽

10.1177/1758573218768510 ◽

2018 ◽

Vol 11 (5) ◽

pp. 359-371 ◽

Cited By ~ 1

Author(s):

David Cinats ◽

Aaron J Bois ◽

Kevin A Hildebrand

Keyword(s):

Range Of Motion ◽

Clinical Outcomes ◽

Published Data ◽

Elbow Arthroplasty ◽

Radiographic Outcomes ◽

Flexion Extension ◽

Functional Outcome Measures

Background The Latitude total elbow arthroplasty (TEA) is an implant with limited published data on its performance and outcomes. The aim of this study was to report the short-term outcomes of the Latitude TEA as well as to describe the radiographic outcomes and complications. Methods The Latitude was implanted in 20 patients (23 elbows) in a linked configuration. Patients were recalled to clinic for the assessment of their range-of-motion and compared to preoperative values. Administration of functional outcome measures was also performed. Results Mean follow-up was 4.7 years (range, 1 to 7.5 years) with four elbows requiring revision. The flexion–extension arc improved from 86.6 to 101.3 (range, 76 to 126) postoperatively (p = 0.04). The average Disabilities of the Arm, Shoulder, and Hand score was 28.1 (range, 5.8 to 50.4) and the average Mayo Elbow Performance Score was 89.6 (range, 76 to 100), with 83% of elbows scoring in the good or excellent range. Radiolucencies were detected in 60% of patients and 31% of these lucencies progressed in size at the time of follow-up. Conclusions The Latitude prosthesis provides patients with favorable clinical outcomes with improvements in their range-of-motion and a complication rate comparable to other elbow arthroplasty implants.

Mid-term results of alumina ceramic unlinked total elbow arthroplasty with cement fixation for patients with rheumatoid arthritis

The Bone & Joint Journal ◽

10.1302/0301-620x.100b8.bjj-2017-1451.r1 ◽

2018 ◽

Vol 100-B (8) ◽

pp. 1066-1073 ◽

Cited By ~ 4

Author(s):

K. Nishida ◽

K. Hashizume ◽

Y. Nasu ◽

M. Ozawa ◽

K. Fujiwara ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Clinical Performance ◽

Radiolucent Line ◽

Humeral Fracture ◽

Deep Infection ◽

Alumina Ceramic ◽

Elbow Arthroplasty ◽

The Mean

Aims The aim of this study was to report the mid-term clinical outcome of cemented unlinked J-alumina ceramic elbow (JACE) arthroplasties when used in patients with rheumatoid arthritis (RA). Patients and Methods We retrospectively reviewed 87 elbows, in 75 patients with RA, which was replaced using a cemented JACE total elbow arthroplasty (TEA) between August 2003 and December 2012, with a follow-up of 96%. There were 72 women and three men, with a mean age of 62 years (35 to 79). The mean follow-up was nine years (2 to 14). The clinical condition of each elbow before and after surgery was assessed using the Mayo Elbow Performance Index (MEPI, 0 to 100 points). Radiographic loosening was defined as a progressive radiolucent line of >1 mm that was completely circumferential around the prosthesis. Results The mean MEPI scores significantly improved from 40 (10 to 75) points preoperatively to 95 (30 to 100) points at final follow-up (p < 0.0001). Complications were noted in ten elbows (ten patients; 11%). Two had an intraoperative humeral fracture which was treated by fixation and united. One had a postoperative fracture of the olecranon which united with conservative treatment and one had a radial neuropathy which resolved. Further surgery was required for one with a dislocation, three with an ulnar neuropathy and one with a postoperative humeral fracture. Revision with removal of the components was performed in one elbow due to deep infection. There was no radiographic evidence of loosening around the components.With any revision surgery or revision with implant removal as the endpoint, the rates of survival up to 14 years were 93% (95% confidence interval (CI), 83.9 to 96.6) and 99% (95% CI 91.9 to 99.8), respectively, as determined by Kaplan-Meier analysis. Conclusion With the appropriate indications, the mid-term clinical performance of the cemented JACE TEA is reliable and comparable to other established TEAs in the management of the elbow in patients with RA. Cite this article: Bone Joint J 2018;100-B:1066–73.

Treatment of complete ankylosed elbow with total arthroplasty

BMJ Case Reports ◽

10.1136/bcr-2019-231123 ◽

2019 ◽

Vol 12 (7) ◽

pp. e231123 ◽

Cited By ~ 1

Author(s):

Riccardo D’Ambrosi ◽

Federica Formiconi ◽

Nicola Ursino ◽

Maurizio Rubino

Keyword(s):

Therapeutic Option ◽

Young Patients ◽

Complete Fusion ◽

Elbow Arthroplasty ◽

Total Arthroplasty ◽

Relieve Pain ◽

Post Traumatic

We reported the case of a 38-year-old patient who in 2017 presented to our institution after post-traumatic complete ankylosis of the elbow. He complained of stiffness and pain, and the radiographs revealed complete fusion of the humeroulnar joint. The Mayo Elbow Performance Score (MEPS) on admission was 31, and the elbow was fused at 90° flexed position. The patient underwent semiconstrained total elbow arthroplasty with Bryan-Morrey approach; after a 2.1 years follow-up, active arc of movement was 120°. The MEPS was excellent with a 100 points score, the patient was able to complete all activities of daily living. We did not report any complications. Total elbow arthroplasty has shown to be a good therapeutic option that make it possible to restore adequate functional range of motion and relieve pain in young patients with post-traumatic stiffness/arthritis of the elbow.

A Review of Total Elbow Arthroplasty and an Early Assessment of the Liverpool Elbow Prosthesis

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681_86_90168-3 ◽

1986 ◽

Vol 11 (3) ◽

pp. 407-413

Author(s):

S. G. SOURMELIS ◽

F. D. BURKE ◽

J. P. W. VARIAN

Keyword(s):

Deep Infection ◽

Early Assessment ◽

Elbow Prosthesis ◽

Secondary Osteoarthritis ◽

Elbow Arthroplasty ◽

Early Results ◽

Flexion Extension ◽

Postoperative Symptoms

The elbow joint is frequently affected by rheumatoid arthritis causing pain and disability which limits the use of the upper limb. Excisional or interpositional arthroplasties of the elbow have failed to provide satisfactory results. The design of a total elbow prosthesis in the early 1970’s followed the principles and evolution of joint replacement in the lower limb. In this study twenty-two Liverpool elbow prostheses (non-constrained) in nineteen patients were reviewed with an average follow-up of 26.5 months. Postoperatively the arc of flexion-extension improved with no change in pronation-supination range. Pain was significantly improved postoperatively. Rheumatoid patients were very pleased, but patients with secondary osteoarthritis were less satisfied. Two prostheses became loose and three had deep infection and were removed. Five patients had postoperative symptoms of ulnar neuritis and in three the symptoms gradually resolved. Early results of total elbow arthroplasty are promising in carefully selected patients.

Two-stage reimplantation for deep infection after total elbow arthroplasty

Shoulder & Elbow ◽

10.1177/17585732211043524 ◽

2021 ◽

pp. 175857322110435

Author(s):

Natalia Martinez-Catalan ◽

Ngoc Tram V Nguyen ◽

Mark E Morrey ◽

Shawn W O’Driscoll ◽

Joaquín Sanchez-Sotelo

Keyword(s):

Persistent Infection ◽

Staphylococcus Epidermidis ◽

Joint Infection ◽

Recurrent Infection ◽

Deep Infection ◽

Two Stage ◽

Elbow Arthroplasty ◽

Associated Risk Factors

Background Persistent infection rate after 2-stage reimplantation complicating elbow arthroplasty has been reported to be as high as 25%. The purposes of this retrospective study were to determine the infection eradication rates, complications and outcomes in a cohort of patients treated with two-stage reimplantation for deep periprosthetic joint infection (PJI) following total elbow arthroplasty (TEA) and to determine possible associated risk factors for treatment failure. Methods Between 2000 and 2017, 52 elbows underwent a two-stage reimplantation for PJI after TEA. There were 22 males and 30 females with a mean age of 61 (range, 25–82) years. The most common bacterium was Staphylococcus epidermidis (28 elbows). Mayo Elbow Performance Scores were calculated at the latest follow-up. Mean follow-up time was 6 years (range, 2–14 years). Results PJI was eradicated in 36 elbows (69%). The remaining 16 elbows were considered treatment failures secondary to recurrent infection. The risk of persistent infection was 3.3 times higher in elbows with retained cement (p 0.04), and 3.5 times higher when the infecting organism was Staphylococcus epidermidis (p 0.06). Conclusion Two-stage reimplantation for PJI after TEA was successful in eradicating deep infection in 69% of cases. The eradication of PJI after TEA still needs to be improved substantially.

Complex fractures of the distal humerus in the elderly: primary total elbow arthroplasty or open reduction and internal fixation? Mid-term follow-up

International Orthopaedics ◽

10.1007/s00264-021-05027-z ◽

2021 ◽

Author(s):

Yaiza Lopiz ◽

Daniel Garríguez-Pérez ◽

Carlos García-Fernández ◽

Laura del Baño ◽

María Galán-Olleros ◽

...

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

The Elderly ◽

Distal Humerus ◽

Elbow Arthroplasty ◽

Complex Fractures

Evaluation of functional outcome after osteosynthesis of intra articular distal humerus fracture with pre contoured locking compression plates

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20204587 ◽

2020 ◽

Vol 6 (6) ◽

pp. 1215

Author(s):

Faisal S. Mohammed ◽

Akshay B. Ingale

Keyword(s):

Functional Outcome ◽

Distal Humerus ◽

Distal Humerus Fracture ◽

Performance Score ◽

Locking Compression Plates ◽

Humerus Fractures ◽

Distal Humerus Fractures ◽

Extensor Lag

Background: Intra articular distal humerus fractures are challenging and cumbersome to treat. Therefore osteosynthesis of such fractures is required. The aim of our study was to evaluate the functional outcome of intra articular distal humerus fractures AO type 13C by osteosynthesis using olecranon osteotomy with pre contoured locking compression plates in orthogonal plate configuration.Methods: Thirty patients were included in our study comprising of 18 males and 12 females. Mean age was 39.63 years with mean follow up of 34 weeks. 7 were AO type 13C1, 9 were AO type 13C2 and 14 were AO type 13C3. Osteosynthesis was done for all fractures by olecranon osteotomy approach. Functional outcome was assessed using mayo elbow performance score.Results: Mean flexion attained at the end of follow up was 127.56 degrees with mean extensor lag of 7.16 degrees. Mean arc of motion was 120.4 degrees. Mean mayo elbow performance score at the end of follow up was 80.36. Mayo elbow performance score in patients aged less than 40 years of age was not statistically significant as compared to patients more than 40 years of age. Functional outcome was also dependent on fracture subtype.Conclusions: Osteosynthesis of distal humerus fractures AO type 13C using pre contoured locking compression plates in orthogonal plate configuration by olecranon osteotomy provides excellent visualization of fracture and better functional outcome.