scholarly journals Total elbow arthroplasty for end-stage rheumatoid elbow arthritis with major instability: a case report

2020 ◽  
Vol 6 (5) ◽  
pp. 1090
Author(s):  
Diogo A. Sousa ◽  
Rita Sapage ◽  
Carlos Branco ◽  
Rita Sousa ◽  
Joao Reis ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Range Of Motion ◽  
Severe Pain ◽  
Daily Activities ◽  
Total Elbow Arthroplasty ◽  
Elbow Arthroplasty ◽  
Active Range Of Motion ◽  
End Stage

<p>A 73 years old female diagnosed with rheumatoid arthritis for over 30 years with an end-stage right elbow arthritis (stage V of Larsen’s classification) with a major instability. The patient presented gross deformity and severe pain with critical limitation of limb function. The patient was treated with a total elbow arthroplasty with an intraoperative olecranon fracture. At six months follow up, the patient presents with an excellent active range of motion and painless joint, without daily activities limitation.</p>

scholarly journals Total Elbow Arthroplasty for Mutilans Deformity with Olecranon Fracture in Rheumatoid Arthritis. A Case Report.

2001 ◽  
Vol 50 (4) ◽  
pp. 1139-1143
Author(s):  
Tsutomu Higashi ◽  
Nobuhiro Kaku ◽  
Mitsuhiro Takashita ◽  
Yuujiro Furushiro ◽  
Shinichi Tokumaru ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Olecranon Fracture ◽  
Total Elbow Arthroplasty ◽  
Elbow Arthroplasty

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

2018 ◽  
Vol 11 (5) ◽  
pp. 359-371 ◽  
Author(s):  
David Cinats ◽  
Aaron J Bois ◽  
Kevin A Hildebrand
Keyword(s):  
Range Of Motion ◽  
Clinical Outcomes ◽  
Total Elbow Arthroplasty ◽  
Published Data ◽  
Mayo Elbow Performance Score ◽  
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.

scholarly journals Establishing the Role of Unlinked Total Elbow Arthroplasty in Low Demand Patients: A Long-Term Follow-up Study

2016 ◽  
Vol 29 (6) ◽  
pp. 367
Author(s):  
Sara Machado ◽  
Isabel Almeida Pinto ◽  
Rui Pinto ◽  
Paulo Ribeiro de Oliveira
Keyword(s):  
Range Of Motion ◽  
Total Elbow Arthroplasty ◽  
Great Loss ◽  
Elbow Arthroplasty ◽  
Mayo Score ◽  
Long Term Follow Up ◽  
Limiting Condition ◽  
Mayo Elbow Score

<p><strong>Introduction:</strong> Experience with total elbow arthroplasty is scarce in most centers. It seems to have a significant rate of associated complications. Most studies are based on non-validated outcome measures and short-term results. <br /><strong>Material and Methods:</strong> We selected patients undergoing unlinked total elbow arthroplasty, with a resultant sample of thirteen cases, with a mean postoperative follow-up of 72 months. We applied the Mayo Elbow Score and all patients underwent an X-ray study, prior to surgery and during the follow-up period. <br /><strong>Results:</strong> All patients have a systemic inflammatory condition. The mean Mayo score increased from 43 points preoperatively to 70 and 80 points at the intermediate follow-up period (with a mean of 15 months after the operation) and at the time of the latest follow-up evaluation (with a mean of 72 months after the operation). There was an increase in range of motion in all cases. There was one case of mechanical failure and two cases of transient ulnar neuropathy. <br /><strong>Discussion:</strong> Elbow dysfunction causes great loss in patient´s quality of life, incapacitating them for the simplest activities. Small improvements in range of motion and pain relief result in significant changes in the patient’s functional ability. There is a demand to clarify the performance of total elbow arthroplasty in selected patient groups in order to throw more light on the relative roles of the available implants. <br /><strong>Conclusions:</strong> The results obtained in this study seem to confirm the long-term benefit of the unlinked arthroplasty in severe joint dysfunction in patients with low physical demand, particularly in rheumatoid arthritis, a common and limiting condition in our population.</p>

Postoperative Infection Related with the Total Elbow Arthroplasty (Kudo’s Prosthesis) in Rheumatoid Arthritis

2018 ◽  
Vol 23 (01) ◽  
pp. 58-65 ◽  
Author(s):  
Michio Minami ◽  
Makoto Kondo ◽  
Yasuhiko Nishio ◽  
Koji Suzuki ◽  
Sadatoshi Kato ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Postoperative Complications ◽  
Postoperative Infection ◽  
The Other ◽  
Total Elbow Arthroplasty ◽  
Implant Design ◽  
Site Infection ◽  
Surgical Scar ◽  
Elbow Arthroplasty

Background: Total Elbow Arthroplasty (TEA) for the rheumatoid arthritis (RA) has been popularized since 1980s. The outcomes of TEA using any type of implant design for RA has been satisfactory. On the other hand, many orthopedicians experience several postoperative complications. Among them, postoperative infection has still being the most troublesome and difficult to treat. This study is to clarify the causes of postoperative infection of TEA using Kudo’s prosthesis for RA and discuss how to manage and prevent infection. Methods: 421 TEAs were performed for 405 cases with RA at the authors’ institute during the period between 1982 and 2007. They were followed up for 1~25 years (Av. 12.3 years). The authors examined pain, the range of motion, roentgenograms and complications postoperatively. We were able to start treatment within 4 weeks after occurrence of infection. For surgical management of infected TEAs, debridement of the synovium and removal of the prosthesis with loosening were performed for all cases. In addition, all cases have been regularly and strictly followed-up with the elbow protector to prevent recurrence of infection since 2008. Results: There were 98 TEAs with the postoperative complications (23.3%). Eight out of 98 TEAs were infected (1.9%). Five of eight infected TEAs were primarily at the surgical scar site infection (SSSI) (60%), unknown causes in two, hematogenous course in 1. It’s obvious that surgical scar site infection (SSSI) was the leading cause of postoperative infection in this study. Thus, the authors made the elbow proctor to avoid injuries of the skin around surgical scar site (SSS). Since 2008, all of the TEAs and revised TEAs have been applied with this protector. Conclusions: The authors reported 8 infected TEAs: 5 cases were revised, 2 with the brace, 1 had above the elbow amputated. The regular and meticulous follow up and application of the elbow protector were useful to prevent infection of post-TEAs using Kudo’s prosthesis in RA. Since 2008, there have been no infection of post TEAs and revised TEAs.

scholarly journals Coonrad-Morrey total elbow arthroplasty for patients with rheumatoid arthritis: 54 prostheses reviewed at 7 years' average follow-up (maximum, 16 years)

2018 ◽  
Vol 27 (3) ◽  
pp. 398-403 ◽  
Author(s):  
Thuy Trang Pham ◽  
Stéphanie Delclaux ◽  
Sandrine Huguet ◽  
Matthieu Wargny ◽  
Nicolas Bonnevialle ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Elbow Arthroplasty ◽  
Elbow Arthroplasty

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

2018 ◽  
Vol 100-B (8) ◽  
pp. 1066-1073 ◽  
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 ◽  
Total Elbow Arthroplasty ◽  
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.

scholarly journals Indications and outcome in total elbow arthroplasty: A systematic review

2019 ◽  
Vol 12 (5) ◽  
pp. 353-361
Author(s):  
Vasileios Samdanis ◽  
Gopikanthan Manoharan ◽  
Robert W Jordan ◽  
Adam C Watts ◽  
Paul Jenkins ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Comparative Studies ◽  
Surgical Techniques ◽  
Case Series ◽  
Total Elbow Arthroplasty ◽  
Surgical Indications ◽  
Elbow Arthroplasty ◽  
End Stage ◽  
Trauma Sequelae

Background Total elbow arthroplasty (TEA) is the established treatment for end-stage rheumatoid arthritis but improved surgical techniques have resulted in expanded indications. The aim of this study is to review the literature to evaluate the evolution of surgical indications for TEA. Methods A systematic review of PubMed and EMBASE databases was conducted. Case series and comparative studies reporting results after three types of primary TEA were eligible for inclusion. Results Forty-nine eligible studies were identified ( n = 1995). The number of TEA cases published annually increased from 6 cases in 1980 to 135 cases in 2008. The commonest indication for TEA throughout the review period was rheumatoid arthritis but its annual proportion reduced from 77% to 50%. The mean Mayo Elbow Performance Score significantly improved for all indications. Three comparative studies reported statistically improved functional outcomes in rheumatoid arthritis over the trauma sequelae group. Complication and revision rates varied; rheumatoid arthritis 5.2–30.9% and 11–13%, acute fracture 0–50% and 10–11%, trauma sequelae 14.2–50% and 0–30%, osteoarthritis 50% and 11%, respectively. Discussion TEA can provide functional improvements in inflammatory arthritis, acute fractures, trauma sequelae and miscellaneous indications. Long-term TEA survivorship appears satisfactory in rheumatoid arthritis and fracture cases; however, further research into alternative surgical indications is still required.

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