1
|
Kondo N, Arai K, Fujisawa J, Murai T, Netsu T, Endo N, Hanyu T. Clinical outcome of Niigata-Senami-Kyocera modular unconstrained total elbow arthroplasty for destructive elbow in patients with rheumatoid arthritis. J Shoulder Elbow Surg 2019; 28:915-924. [PMID: 30630713 DOI: 10.1016/j.jse.2018.10.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 10/23/2018] [Accepted: 10/28/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Total elbow arthroplasty (TEA) is a treatment option for destructive and painful unstable elbows in rheumatoid arthritis (RA). We evaluated the clinical outcomes of unconstrained TEA (Niigata-Senami-Kyocera modular system). METHODS Seventy-five unconstrained TEAs were performed in patients with RA (mean age, 64 years; age range, 41-79 years; follow-up rate, 97%). Outcome measures included the Japanese Orthopaedic Association (JOA) functional evaluation score for the elbow joint (JOA score), range of motion, and arc. Bone ingrowth of the humeral component, the incidence of stress shielding around the humeral component, the incidence of loosening of the ulnar component, complications, and the survival rate were investigated. RESULTS The mean follow-up period was 5.2 years (range, 2-11.3 years). The JOA elbow score improved from 42 points preoperatively to 87 points postoperatively (P < .0001). Each specified item improved (P < .0001). Flexion improved from 109° to 134°; the flexion-plus-extension arc improved from 70° to 108° (P < .0001). Bone ingrowth of the humeral implant was achieved in all elbows. Stress shielding of the humeral component was detected in 11 elbows (14%); it was significantly higher in 10- and 9-mm-diameter humeral stems than in 8-mm-diameter humeral stems (P = .008). The ulnar component showed no loosening except in 1 elbow owing to infection. Complications were detected in 9 patients (9 elbows, 12%): periprosthetic infection (3), fracture (4), and dislocation (2). The survival rates were 97% at 5 years and 93% at 10 years postoperatively. DISCUSSION The Niigata-Senami-Kyocera modular system for patients with RA showed good outcomes. Stress shielding can be avoided by using an 8-mm-diameter humeral stem.
Collapse
Affiliation(s)
- Naoki Kondo
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Katsumitsu Arai
- Department of Orthopedic Surgery, Niigata Prefectural Central Hospital, Joetsu, Japan
| | - Junichi Fujisawa
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takehiro Murai
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takahiro Netsu
- Department of Rheumatology, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Naoto Endo
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Tadamasa Hanyu
- Department of Rheumatology, Nagaoka Red Cross Hospital, Nagaoka, Japan
| |
Collapse
|
2
|
Nishida K, Hashizume K, Nasu Y, Ozawa M, Fujiwara K, Inoue H, Ozaki T. Mid-term results of alumina ceramic unlinked total elbow arthroplasty with cement fixation for patients with rheumatoid arthritis. Bone Joint J 2018; 100-B:1066-1073. [PMID: 30062938 PMCID: PMC6413761 DOI: 10.1302/0301-620x.100b8.bjj-2017-1451.r1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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.
Collapse
Affiliation(s)
- K Nishida
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - K Hashizume
- Department of Rehabilitation, Japan Labour Health and Welfare Organization, Okayama Rosai Hospital, Okayama, Japan
| | - Y Nasu
- Department of Medical Materials for Musculoskeletal Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - M Ozawa
- Department of Orthopaedic Surgery, Okayama City Hospital, Okayama, Japan
| | - K Fujiwara
- Department of Intelligent Orthopaedic System Development, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - H Inoue
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - T Ozaki
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| |
Collapse
|
3
|
Singh JA, Ramachandran R. Are there racial disparities in utilization and outcomes after total elbow arthroplasty? Rheumatol Int 2015; 35:1479-87. [PMID: 25812536 DOI: 10.1007/s00296-015-3252-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 03/09/2015] [Indexed: 01/10/2023]
Abstract
The aim of the study was to assess racial disparities in utilization rates and outcomes after primary total elbow arthroplasty (TEA). We used the National Inpatient Sample from 1998 to 2010, a US national database. Patient characteristics, comorbidity and outcomes after TEA were assessed over time and differences by race studied over the study period. Cochran-Armitage test was used for time trends and logistic regression for the comparison of outcomes by race. In 1998, TEA utilization rate was 0.38/100,000 in Whites and 0.24/100,000 in Blacks (p = 0.002); in 2010, it was 0.91 and 0.59/100,000, respectively (p < 0.0001). White-Black disparity in TEA utilization was significant across 13 years (p = 0.03). Compared with White patients, Black patients undergoing TEA were younger (61.9 vs. 52 years; p < 0.0001), less likely to be female (70.6 vs. 61.4 %; p = 0.0007) and more likely to have rheumatoid arthritis as the underlying diagnosis (13.0 vs. 17.2 %; p = 0.036). Mortality was rare, 0.26 % in Blacks and 0.32 % in Whites (p = 0.83). Discharge to an inpatient facility was higher in White versus Black patients in unadjusted analyses (16.8 vs. 10.4 %; p = 0.003), but in analyses adjusted for age, sex, Deyo-Charlson index and the underlying diagnosis, the differences were no longer significant (p = 0.79). The length of hospital stay greater than the median stay was noted in 29.8 % Whites versus 31.2 % Blacks, respectively (p = 0.61). There was no evidence of White-Black disparity in hospital length of stay in 1998-2000 (p = 0.66) or 2009-2010 (p = 0.59) periods. In this study, we found persisting racial disparities in TEA utilization rates. No White-Black disparities were noted in TEA outcomes, except slight differences in discharge disposition.
Collapse
Affiliation(s)
- Jasvinder A Singh
- Medicine Service, Birmingham VA Medical Center, Birmingham, AL, USA,
| | | |
Collapse
|
4
|
Total elbow arthroplasty: a prospective clinical outcome study of Discovery Elbow System with a 4-year mean follow-up. J Shoulder Elbow Surg 2015; 24:52-9. [PMID: 25441571 DOI: 10.1016/j.jse.2014.08.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 08/12/2014] [Accepted: 08/13/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND Total elbow arthroplasty (TEA) is increasingly used for the treatment of advanced elbow conditions to reduce pain and improve function. However, TEA is still associated with a higher complication rate than total hip and knee arthroplasty despite advances in the design and surgical techniques. This prospective clinical study reports the outcome of the Discovery Elbow System (Biomet, Warsaw IN, USA), which has been in clinical use in the United Kingdom since 2003. METHODS The study included a total of 100 Discovery Elbows (April 2003 to January 2010) with a minimum 2-year follow-up, including 75 primary and 25 revisions (60% women and 40% men; mean age, 62 years). Outcome was assessed by means of the Liverpool Elbow Score, pain experience, patient satisfaction, range of motion, and radiographic imaging. RESULTS The mean follow-up period was 48.5 months (range, 24-108 months). The Liverpool Elbow Score improved from 3.79 to 6.36 (P < .001). The percentage of pain-free patients was substantially increased from 7% preoperatively to 64% at the final follow-up. The patient satisfaction rate was over 90%. The flexion-extension arc and pronation-supination arc increased from 72° to 93° and from 86° to 111°, respectively (P < .001). Major postoperative complications included deep infection (2%), progressive aseptic loosening requiring revision (primary, 5%; revision 12%), persistent ulnar neuropathy (3%), and periprosthetic fracture (primary, 6.8%; revision, 8%). CONCLUSION The Discovery Elbow System resulted in improved function, reduced pain, and high patient satisfaction. Long-term results are required to assess the survivorship of this system.
Collapse
|
5
|
Short-term results of the PROSNAP linked elbow prosthesis with a snap-in structure and modular flange for the reconstruction of severely damaged rheumatoid elbows. J Shoulder Elbow Surg 2014; 23:837-42. [PMID: 24656309 DOI: 10.1016/j.jse.2013.12.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 12/20/2013] [Accepted: 12/25/2013] [Indexed: 02/01/2023]
Abstract
BACKGROUND We aimed to evaluate the early clinical results of the reconstruction of problematic elbow joints due to rheumatoid arthritis (RA) using a PROSNAP linked elbow prosthesis (Kyocera Medical, Osaka, Japan) for total elbow arthroplasty. METHODS Seventeen elbows in 14 RA patients were replaced with a PROSNAP elbow with cement fixation. The patients comprised 1 man and 13 women, with a mean age of 63.9 years (range, 52-83 years) at the time of surgery. The preoperative conditions of the elbows were arthritis mutilans (n = 10), an ankylosed or stiff elbow with a preoperative range of motion of 45° or less (n = 4), and loosening of a primary total elbow arthroplasty (n = 3). The mean follow-up period was 47.7 months (range, 32-69 months), with a 100% follow-up rate. The clinical outcome of the elbows was evaluated by the Mayo Elbow Performance Index (maximum, 100 points). RESULTS The mean postoperative Mayo Elbow Performance Index score improved from 57.6 points to 97.1 points. Preoperatively, 3 of the 17 elbows were judged as good, 7 as fair, and 7 as poor; at final follow-up, 16 elbows were judged as excellent and 1 as good. Complications were noted in 1 elbow (6%), which had undergone a postoperative fracture. CONCLUSIONS The PROSNAP elbow prosthesis can be safely implanted through a relatively easy procedure and provides satisfactory short-term clinical outcomes for the reconstruction of severely damaged RA elbows. LEVEL OF EVIDENCE Level IV, case series, treatment study.
Collapse
|
6
|
Implant survival after total elbow arthroplasty: a retrospective study of 324 procedures performed from 1980 to 2008. J Shoulder Elbow Surg 2014; 23:829-36. [PMID: 24766794 DOI: 10.1016/j.jse.2014.02.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 02/04/2014] [Accepted: 02/10/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND Total elbow arthroplasty (TEA) is an established treatment for late-stage arthritis of the elbow. Indications have expanded to osteoarthritis and nonunion in distal humeral fractures. Information on implant survival and risk factors for revision is still sparse. The aim of this study was to evaluate implant survival and risk factors for revision of TEAs inserted in patients in the eastern part of Denmark in the period from 1980 until 2008. MATERIAL AND METHODS The Danish National Patient Register provided personal identification numbers for patients who underwent TEA procedures from 1980 until 2008. On the basis of a review of medical reports and linkage to the National Patient Register, we calculated revision rates and evaluated potential risk factors for revision, including, age, sex, period, indication for TEA, and implant design. RESULTS We evaluated 324 primary TEA procedures in 234 patients at a mean follow-up of 8.7 years (range, 0-27 years). The overall 5-year survival was 90% (95% confidence interval [CI], 88%-94%), and 10-year survival was 81% (95% CI, 76%-86%). TEAs performed with the unlinked design had a relative risk of revision of 1.9 (95% CI, 1.1-3.2) compared with the linked design. Fracture sequelae was associated with a relative risk of revision of 1.9 (95% CI, 1.05-3.45). CONCLUSIONS We found acceptable implant survival rates after 5 and 10 years, with a higher revision rate for the unlinked design and primary TEA due to fracture sequelae. Patient-related outcome measures should be included in future studies for further elaboration of the outcomes after TEA. LEVEL OF EVIDENCE Level III, Retrospective cohort design, treatment study.
Collapse
|
7
|
Gasparyan AY, Ayvazyan L, Akazhanov NA, Kitas GD. Self-correction in biomedical publications and the scientific impact. Croat Med J 2014; 55:61-72. [PMID: 24577829 PMCID: PMC3944419 DOI: 10.3325/cmj.2014.55.61] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 02/15/2014] [Indexed: 01/17/2023] Open
Abstract
AIM To analyze mistakes and misconduct in multidisciplinary and specialized biomedical journals. METHODS We conducted searches through PubMed to retrieve errata, duplicate, and retracted publications (as of January 30, 2014). To analyze publication activity and citation profiles of countries, multidisciplinary, and specialized biomedical journals, we referred to the latest data from the SCImago Journal and Country Rank database. Total number of indexed articles and values of the h-index of the fifty most productive countries and multidisciplinary journals were recorded and linked to the number of duplicate and retracted publications in PubMed. RESULTS Our analysis found 2597 correction items. A striking increase in the number of corrections appeared in 2013, which is mainly due to 871 (85.3%) corrections from PLOS One. The number of duplicate publications was 1086. Articles frequently published in duplicate were reviews (15.6%), original studies (12.6%), and case reports (7.6%), whereas top three retracted articles were original studies (10.1%), randomized trials (8.8%), and reviews (7%). A strong association existed between the total number of publications across countries and duplicate (rs=0.86, P<0.0001) and retracted items (rs=0.812, P<0.0001). A similar trend was found between country-based h-index values and duplicate and retracted publications. CONCLUSION The study suggests that the intensified self-correction in biomedicine is due to the attention of readers and authors, who spot errors in their hub of evidence-based information. Digitization and open access confound the staggering increase in correction notices and retractions.
Collapse
Affiliation(s)
- Armen Yuri Gasparyan
- Armen Yuri Gasparyan, Departments of Rheumatology and Research and Development, Dudley Group NHS Foundation Trust, Russells Hall Hospital, North Block, Clinical Research Unit, Dudley, West Midlands, DY1 2HQ, United Kingdom,
| | | | | | | |
Collapse
|
8
|
Nishida K, Hashizume K, Nasu Y, Kishimoto M, Ozaki T, Inoue H. A 5-22-year follow-up study of stemmed alumina ceramic total elbow arthroplasties with cement fixation for patients with rheumatoid arthritis. J Orthop Sci 2014; 19:55-63. [PMID: 24197059 DOI: 10.1007/s00776-013-0492-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 10/21/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND We determined mid to long-term results of total elbow arthroplasty (TEA) by use of unlinked elbow prostheses with solid alumina ceramic trochleae, and ceramic ulnar stems (stemmed Kyocera type I; SKC-I) for patients with rheumatoid arthritis. PATIENTS AND METHODS Fifty-four elbows of 39 patients were available for detailed clinical and radiographic review after a follow-up period of at least 5 years. The mean follow-up period was 12.6 years (range 5-22 years). Clinical condition before and after surgery was assessed by use of a modified version of the Mayo Elbow Performance Score (MEPS; 0-100 points) and a Japan Orthopaedic Association Elbow score (JOA score; 0-100 points). The radiographs were reviewed and loosening was defined as a progressive radiolucent line >1 mm wide that was completely circumferential around the prosthesis. Clinical records of post-operative events affecting the elbows were used for survival analysis of the prostheses using the Kaplan-Meier method. RESULTS The average modified MEPS and JOA scores improved significantly from 39.7 ± 14.3 to 44.7 ± 9.4, respectively, pre-operatively, to 89.7 ± 15.4 and 83.1 ± 12.8, respectively, post-operatively (P < 0.0001). The functional assessment score also improved from 4.9 ± 2.8 to 8.5 ± 3.3 points (P < 0.0001). With loosening or implant revision defined as end points, the likelihood of survival of the prosthesis for up to 20 years was 92.6% (95% confidence interval (CI), 85.6-100.0) or 86.3 % (95 % CI 75.0-97.6), respectively. CONCLUSION Satisfactory clinical results were obtained after TEA using SKC-I prostheses, which provided excellent pain relief and functional range of motion. The results of our study reveal the high reliability over a long period of the cemented SKC-I prosthesis with an alumina ceramic component.
Collapse
Affiliation(s)
- Keiichiro Nishida
- Department of Human Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan,
| | | | | | | | | | | |
Collapse
|
9
|
Jung HJ, Jeon IH, Chun JM, Lee TK. Linked (Semi-constrained) Total Elbow Arthroplasty. Clin Shoulder Elb 2013. [DOI: 10.5397/cise.2013.16.2.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
10
|
Park SE, Kim JY, Cho SW, Rhee SK, Kwon SY. Complications and revision rate compared by type of total elbow arthroplasty. J Shoulder Elbow Surg 2013; 22:1121-7. [PMID: 23664747 DOI: 10.1016/j.jse.2013.03.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Accepted: 03/04/2013] [Indexed: 02/01/2023]
Abstract
BACKGROUND This study evaluates the long-term results, including complication and revision rates, of different types of total elbow arthroplasty (TEA) with an average follow up of 13 years. METHODS Since 1984, a total of 84 primary TEAs have been performed in 77 patients at our institution. The patient's average age was 54.2 years. We performed unlinked TEA in 35 cases (Pritchard ERS since 1984 [n = 18], Kudo type 3 since 1991 [n = 17]), and semi-linked TEA in 49 cases (Pritchard Mark II since 1997 [n = 14], Coonrad-Morrey since 2001 [n = 35]). We assessed the patients for compliance to daily living guidelines (not to exceed 2.25 kg for repetitive lifting and 4.5 kg for single episode lifting), and followed up with them for an average of 13 years after primary TEA. We analyzed their results with regard to complication and revision rates as the type of TEA. RESULTS The mean Mayo Elbow Performance Score (MEPS) improved from preoperative 34 points to postoperative 84 points. The active flexion-extension elbow motion increased from 25°-94° preoperative to 12°-130° postoperative. The overall complication rate was 44.0% (37/84 cases); the rate was statistically higher in the unlinked group (62.9%, 22/35 cases) than in the semi-linked group (30.6%, 15/49 cases). The overall revision rate was 27.4% (23/84 cases); the rate was higher in the unlinked group (34.3%, 12/35 cases) than in the semi-linked group (22.4%, 11/49 cases). CONCLUSION Semi-linked TEA has better outcomes than unlinked TEA with respect to complication and revision rates; but continuous efforts to develop a new TEA design for longevity, improved cementing technique, and supporting activities of daily living are needed to reduce complication and revision rates in the future.
Collapse
Affiliation(s)
- Sang-Eun Park
- Department of Orthopaedic Surgery, Daejeon St. Mary's Hospital, The Catholic University Medical College, Seoul, South Korea
| | | | | | | | | |
Collapse
|
11
|
Kodde IF, van Riet RP, Eygendaal D. Semiconstrained total elbow arthroplasty for posttraumatic arthritis or deformities of the elbow: a prospective study. J Hand Surg Am 2013; 38:1377-82. [PMID: 23746397 DOI: 10.1016/j.jhsa.2013.03.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2012] [Revised: 03/25/2013] [Accepted: 03/26/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE To report the short-term results for posttraumatic total elbow arthroplasty. METHODS We included patients presenting to our hospital with symptomatic chronic posttraumatic arthritis or deformities of the elbow, aged 55 to 90 years. All patients had reconstruction with a Coonrad-Morrey prosthesis. We performed clinical follow-up after 2, 6, 12, 24, and 36 months, consisting of physical examination, standard radiographs, and calculation of the Mayo elbow performance index. RESULTS A total of 17 patients were enrolled in this study and had a mean follow-up of 32 months. Mean preoperative flexion arc was 67° and 105° postoperatively. The mean preoperative Mayo elbow performance index score was 54 (range, 30-80) and improved to a postoperative score of 93 (range, 60-100). We encountered 6 complications in 5 patients. Four complications required surgical intervention and 2 minor complications were treated noninvasively. CONCLUSIONS Short-term functional outcomes after total elbow arthroplasty in this prospective cohort of patients with posttraumatic arthritis or deformities of the elbow were good according to mean postoperative measurements.
Collapse
Affiliation(s)
- Izaäk F Kodde
- Department of Orthopaedics, Upper Limb Unit, Amphia Hospital, Breda, The Netherlands.
| | | | | |
Collapse
|
12
|
Surgical management of osteoarthritis. Wien Med Wochenschr 2013; 163:243-50. [DOI: 10.1007/s10354-013-0199-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 03/26/2013] [Indexed: 12/31/2022]
|
13
|
Plaschke HC, Thillemann T, Belling-Sørensen AK, Olsen B. Revision total elbow arthroplasty with the linked Coonrad-Morrey total elbow arthroplasty: a retrospective study of twenty procedures. INTERNATIONAL ORTHOPAEDICS 2013; 37:853-8. [PMID: 23420324 DOI: 10.1007/s00264-013-1821-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 01/31/2013] [Indexed: 12/16/2022]
Abstract
PURPOSE In this retrospective study we evaluated the short- to medium-term results after 20 Coonrad-Morrey revision total elbow arthroplasties (TEAs). METHODS We included a consecutive series of revision TEAs performed at our institution from 2004 to 2010. At a mean follow-up of 4.4 years, patients were evaluated using the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES) and standard radiographs. RESULTS The mean age at revision TEA was 65.8 years. The median time of implant survival for primary prosthesis was 9.5 years. The mean post-operative MEPS was 79. The mean OES was 58, 66 and 53 for function, pain and social-psychological dimensions, respectively. At follow-up the range of motion had improved significantly. There were two cases of radiolucent lines and two cases of minor bushing wear; however, none of the implants were clinically loose. In one case deep infection led to a further revision. Two patients had post-operative ulnar nerve paraesthesia. CONCLUSIONS Results after revision TEA using the Coonrad-Morrey prosthesis are acceptable with a low short- to midterm failure rate. Revision improves range of motion and provides pain relief. One case of deep infection with recurrent revision is of concern. The treatment can be used as an option for failed TEA.
Collapse
|
14
|
|