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Meijering D, Boerboom AL, Gerritsma CLE, de Vries AJ, Vegter RJK, Bulstra SK, Eygendaal D, Stevens M. Mid-term results of the Latitude primary total elbow arthroplasty. J Shoulder Elbow Surg 2022; 31:382-390. [PMID: 34619349 DOI: 10.1016/j.jse.2021.08.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/25/2021] [Accepted: 08/29/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND The Latitude total elbow prosthesis is a third-generation implant, developed to restore the natural anatomy of the elbow. Literature on this prosthesis is scarce. The aim of this study was to analyze the mid-term results of the Latitude total elbow prosthesis. METHODS We retrospectively evaluated 62 patients (21 men and 41 women). The mean age at the time of surgery was 65 years (range, 28-87 years). The main indication for surgery was inflammatory arthritis. The outcome measures were complications, reoperations, self-reported physical functioning, pain, satisfaction, objectively measured physical functioning, and radiologic signs of loosening. Kaplan-Meier survival analysis was used to determine survival with revision as the endpoint. RESULTS Sixty-nine primary Latitude prostheses were placed in 62 patients between 2008 and 2019. Six patients (7 prostheses) died, 3 elbows underwent revision, and 9 patients were lost to follow-up. A total of 44 patients (50 prostheses) were available for follow-up. The mean length of follow-up was 51 months (range, 10-144 months). Kaplan-Meier survival analysis showed a survival rate of 82% at 10 years after surgery. The main reason for revision was aseptic loosening. Radial head dissociation was seen in 8 patients (24%), but none had complaints. Self-reported and objectively measured physical functioning yielded good results, although 23 patients (46%) did show radiolucent lines on radiographs. CONCLUSION Latitude total elbow arthroplasty is considered a successful procedure with low pain scores, high patient satisfaction, and good physical functioning. Survival rates nonetheless remain low and complication rates remain high yet are comparable to those of other elbow arthroplasties. We recommend biomechanical studies to concentrate on specific postoperative loading instructions to minimize wear and consequent loosening.
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Affiliation(s)
- Daniëlle Meijering
- Department of Orthopedic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Alexander L Boerboom
- Department of Orthopedic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Astrid J de Vries
- Department of Orthopedic Surgery, Martini Hospital, Groningen, The Netherlands
| | - Riemer J K Vegter
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sjoerd K Bulstra
- Department of Orthopedic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Denise Eygendaal
- Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands; Department of Orthopedic Surgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Martin Stevens
- Department of Orthopedic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Domos P, Chelli M, Papanna MC, Gokaraju K, Stanley D, Ali AA. Outcomes following revision of the revision total elbow arthroplasty. J Shoulder Elbow Surg 2021; 30:1653-1661. [PMID: 33220416 DOI: 10.1016/j.jse.2020.10.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND There is very little information in the literature on the outcomes of revision of revision total elbow arthroplasty (RRTEA). Our aim was to report the outcomes of this rarely performed procedure. METHODS We retrospectively identified all patients who had undergone RRTEA between 2007 and 2016. Outcomes were assessed clinically using a number of validated systems, and radiographs were reviewed for prosthesis alignment, cementation by Morrey grading, and heterotopic ossification. RESULTS We identified 22 patients who underwent RRTEA. Of these patients, 14 were available for assessment (2 died of unrelated causes, 2 could not be contacted, 2 declined to participate because of travel difficulties, and 2 had incomplete data). At the final review, the median age was 73 years (range, 57-83 years), with a median follow-up period of 4.5 years (range, 2-7 years) since the last surgical procedure. The median number of previous revision arthroplasty procedures per patient was 3 (range, 2-6). The indications for RRTEA were aseptic loosening (60%), bushing wear (16%), fracture (14%), and infection (10%). Of the patients, 30% required extra-long or custom-made implants and 50% needed allograft augmentation. At final clinical assessment, 56% of patients had triceps insufficiency, the median flexion-extension arc was 90°, and the median prono-supination arc was 95°. The functional elbow scores revealed good outcomes in the majority of patients (median visual analog scale score, 5; median Oxford Elbow Score, 22; median Mayo Elbow Performance Index score, 55; and median QuickDASH [short version of Disabilities of the Arm, Shoulder and Hand questionnaire] score, 63). Eighty-one percent of patients were satisfied with their RRTEAs. Complications included infection in 2 patients (1 superficial and 1 deep), symptomatic aseptic humeral component loosening in 1, sensory ulnar nerve symptoms in 2, and radial nerve injury in 1. One patient required ulnar nerve release. Radiologic review revealed asymptomatic loosening in 1 patient (humeral component), and overall prosthesis alignment with cementation was adequate in 81%. Heterotopic ossification was present in 38% of cases. CONCLUSIONS RRTEA is a satisfactory treatment option in these complex cases, with good short- to mid-term survival rates but a relatively high complication rate.
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Affiliation(s)
- Peter Domos
- Royal Free London NHS Foundation Trust, Barnet and Chase Farm Hospitals, London, UK.
| | - Mikaël Chelli
- Institut Universitaire Locomoteur & Sport, Hôpital Pasteur 2, Nice, France
| | | | - Kishan Gokaraju
- Royal Free London NHS Foundation Trust, Barnet and Chase Farm Hospitals, London, UK
| | - David Stanley
- Sheffield Teaching Hospitals NHS Trust, Northern General Hospital, Sheffield, UK
| | - Amjid A Ali
- Sheffield Teaching Hospitals NHS Trust, Northern General Hospital, Sheffield, UK
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3
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Long-term outcomes of total elbow arthroplasty: a systematic review of studies at 10-year follow-up. J Shoulder Elbow Surg 2021; 30:1423-1430. [PMID: 33418089 DOI: 10.1016/j.jse.2020.11.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/08/2020] [Accepted: 11/16/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND The purpose of this study was to systematically review the literature to evaluate the functional outcomes, dislocation, and revision rates following total elbow arthroplasty (TEA) at a minimum 10 years' mean follow-up. MATERIALS AND METHODS Two independent reviewers performed a literature search using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using PubMed, Embase, and Cochrane Library databases. Studies were only included if they focused on outcomes post-TEA at a minimum 10 years' mean follow-up. RESULTS Our search found 23 studies including 1429 elbows (60.4% linked TEA) that met our inclusion criteria. There were 1276 patients (79.0% female), with an average age of 64.7 years (19-93) and a mean follow-up of 137.2 months (120-216). At final follow-up, the mean Mayo Elbow Performance Score, Oxford Elbow Score, and Quick Disabilities of the Arm, Shoulder, and Hand scores were 89.1 (35-100), 64.4 (16-48), and 39.2 (3-93), respectively, and 63.3% of patients reported having no pain. The rates of aseptic loosening, infection, implant dislocation, and nerve injury were 12.9%, 3.3%, 4.2%, and 2.1%, respectively. The overall complication and revision rates were 16.3% and 14.6%, respectively. DISCUSSION AND CONCLUSION Our systematic review established that TEA offers patients satisfactory clinical outcomes at long-term follow-up, with relatively stable revision and complication rates compared to short and medium term.
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4
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Brinke BT, Kosse NM, Flikweert PE, van der Pluijm M, Eygendaal D. Long-term outcomes after Instrumented Bone Preserving total elbow arthroplasty: a radiostereometric study with a minimum follow-up of 10 years. J Shoulder Elbow Surg 2020; 29:126-131. [PMID: 31564575 DOI: 10.1016/j.jse.2019.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 07/01/2019] [Accepted: 07/08/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Aseptic loosening is a main concern in elbow arthroplasty. Evaluation of implant migration using radiostereometric analysis (RSA) might increase understanding of implant loosening. Previously, 2-year RSA results of 16 Instrumented Bone Preserving (IBP) elbow prostheses showed migration of the humeral component in the first weeks but most components stabilized within 6 months postoperatively. In follow-up, the present study evaluated long-term survival, the relation between early migration and survival, and the long-term migration and clinical outcomes. METHODS Sixteen patients who received an IBP prosthesis were prospectively followed with a median follow-up time of 136 months (range 82-165). Migration was measured using RSA. Clinical results were described using the Elbow Function Assessment (EFA), Broberg and Morrey elbow functional rating index, Oxford Elbow Score (OES), and visual analog scale (VAS) for pain and satisfaction. RESULTS Four patients underwent a revision within 10 years, and 2 more were planned for revision surgery after 14 years. Five patients died with their prosthesis in situ. Early migration was not associated with survival. Long-term migration patterns varied widely. Median EFA score was 58.5, Broberg and Morrey score was 50, and OES score was 32. Median VAS score for pain was 2 and that for satisfaction was 7.5. CONCLUSION Ten-year survival of the IBP total elbow prosthesis was 75%, decreasing to 63% after 14 years of follow-up. Long-term implant failure could not be predicted by 2-year migration results in this study. Although short-term clinical results were promising, long-term outcomes worsened in all patients.
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Affiliation(s)
- Bart Ten Brinke
- Department of Orthopaedic Surgery, Reinier de Graaf, Delft, the Netherlands.
| | - Nienke M Kosse
- Sint Maartenskliniek Research, Nijmegen, the Netherlands
| | - Petra E Flikweert
- Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Marco van der Pluijm
- Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Denise Eygendaal
- Department of Orthopaedic Surgery, Amsterdam UMC, Amsterdam, the Netherlands; Department of Orthopaedic Surgery, Amphia Ziekenhuis, Breda, the Netherlands
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5
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Meijering D, Boerboom AL, Breukelman F, Eygendaal D, Bulstra SK, Stevens M. Long-term results of the iBP elbow prosthesis: beware of destructive metallosis! BMC Musculoskelet Disord 2019; 20:415. [PMID: 31488129 PMCID: PMC6729027 DOI: 10.1186/s12891-019-2781-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 08/26/2019] [Indexed: 11/23/2022] Open
Abstract
Background The aim of this study was to review the long-term results of the instrumented Bone Preserving (iBP) elbow prosthesis. Methods Thirty-one patients (10 M, 21F, 28-77 year) were retrospectively evaluated using the Oxford Elbow Score (OES), Disabilities of Arm, Shoulder and Hand Outcome Measure (DASH), Mayo Elbow Performance (MEPS), physical examination and standard radiographs. Kaplan-Meier survival analysis was used. Results Thirty-seven primary iBPs have been placed in 31 patients between 2000 and 2007. Six patients (8 prostheses) had died, 10 elbows had been revised and three patients (4 prostheses) were lost to follow-up. Fourteen patients (15 prostheses) were available for follow-up. The main indication for surgery was rheumatoid arthritis. Mean follow-up was 11 years (8–15). Kaplan-Meier survival analysis showed a survival of 81% at 10 years after surgery. Main reason for revision was particle disease and loosening due to instability and malalignment. Eleven of 14 patients were satisfied, although radiographs showed radiolucencies in 11 patients. Conclusion The iBP elbow prosthesis gives a survival rate of 81% 10 years after surgery with a progressive decline beyond 10 years. However, many patients have radiolucencies. Discrepancy between clinical signs and radiological results warrants structural follow-up, to assure quality of bone stock in case revision surgery is indicated. The study was reviewed and approved by the Medical Ethical Committee of University Medical Center Groningen (METc2016/038). Level of evidence Level IV, Case series.
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Affiliation(s)
- Daniëlle Meijering
- Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Alexander L Boerboom
- Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Fred Breukelman
- Orthopedic Department, Wilhelmina Hospital, Assen, The Netherlands
| | - Denise Eygendaal
- Department of Orthopedic Surgery, Amsterdam Medical Center, Amsterdam, The Netherlands.,Orthopedic Surgery Department, Amphia Hospital, Breda, the Netherlands
| | - Sjoerd K Bulstra
- Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Martin Stevens
- Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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6
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Geurts EJ, Viveen J, van Riet RP, Kodde IF, Eygendaal D. Outcomes after revision total elbow arthroplasty: a systematic review. J Shoulder Elbow Surg 2019; 28:381-386. [PMID: 30658776 DOI: 10.1016/j.jse.2018.08.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/14/2018] [Accepted: 08/19/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Although revision arthroplasty surgery is a frequently used treatment for failed total elbow arthroplasty (TEA), published results are conflicting. The aim of this systematic review was to provide an overview of the outcomes of revision TEA surgery. METHODS A systematic literature search was performed in major databases to find articles relating to outcomes after revision of TEA. Two reviewers independently screened the articles for inclusion, and a third reviewer screened them before final inclusion. RESULTS Twenty-one articles containing 532 cases were included. The mean age at revision was 61 years. The mean interval between primary and revision arthroplasty was 77 months, and the average follow-up period was 65 months. Different types of prostheses were included, with 69% of the revision prostheses having linked designs and 31% having unlinked designs. The visual analog scale score, Mayo Elbow Performance Score, Oxford Elbow Score, and range of motion improved significantly after revision surgery. Complications were reported in 232 of 532 cases (44%), leading to reoperations in 22%. After revision with linked prostheses, the Mayo Elbow Performance Score, range of flexion-extension, and pronation improved significantly more than with unlinked designs. CONCLUSION Improved functional outcomes can be expected after revision TEA, but the complication rate remains high. Revision TEA should still be considered a salvage procedure for failed TEA. Linked designs for revision TEA result in better outcomes than unlinked designs in the midterm follow-up.
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Affiliation(s)
- Elisabeth J Geurts
- Department of Orthopedics, Academic Medical Center, Amsterdam, The Netherlands.
| | - Jetske Viveen
- Department of Orthopedics, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Izaäk F Kodde
- Department of Orthopedics, Academic Medical Center, Amsterdam, The Netherlands
| | - Denise Eygendaal
- Department of Orthopedics, Academic Medical Center, Amsterdam, The Netherlands; Upper Limb Unit, Department of Orthopedic Surgery, Amphia, Breda, The Netherlands
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7
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Nakayama M, Sakuma Y, Imamura H, Yano K, Ikari K. Long-term Outcome of Open Synovectomy with Radial Head Resection for Rheumatoid Elbow. J Hand Surg Asian Pac Vol 2018; 23:192-197. [PMID: 29734890 DOI: 10.1142/s2424835518500194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND We reviewed our surgical results of open synovectomy with radial head resection for rheumatoid elbow. METHODS We reviewed the 20 patients (22 elbows) underwent open synovectomy for rheumatoid elbows retrospectively. The minimum follow-up period is over 10 years, and the average was 13 years 4 months. Surgical outcomes were evaluated using the VAS pain scale, range of motion, and radiologic outcomes including Larsen's grade and carrying angle. RESULTS The mean VAS score was 39 (range, 10-90) at last follow-up. The only one patient underwent revision surgery. The mean flexion-extension range of elbow was -28°-112° and arc of motion was 82° before surgery. The mean flexion-extension range of elbow was -23°-114°, and arc of motion was 90° at last follow-up. Radiologic findings of nine elbows in 21 elbows worsened at last follow-up according to the Larsen-s grade. Carrying angle increased by mean 4.2°, and it increased by 10° or more in four elbows. CONCLUSIONS Our results show that open synovectomy with radial head resection resulted in functional motion maintenance and pain control for a long time, but often resulted in an elbow valgus deformity. Our findings suggest open synovectomy can be considered as palliative treatment for painful rheumatoid elbow.
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Affiliation(s)
- Masanori Nakayama
- * Department of Orthopedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yu Sakuma
- * Department of Orthopedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hitoshi Imamura
- * Department of Orthopedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Koichiro Yano
- * Department of Orthopedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
| | - Katsunori Ikari
- * Department of Orthopedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan
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8
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Ten Brinke B, Beumer A, Koenraadt KLM, Eygendaal D, Kraan GA, Mathijssen NMC. The accuracy and precision of radiostereometric analysis in upper limb arthroplasty. Acta Orthop 2017; 88:320-325. [PMID: 28464752 PMCID: PMC5434603 DOI: 10.1080/17453674.2017.1291872] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - Radiostereometric analysis (RSA) is an accurate method for measurement of early migration of implants. Since a relation has been shown between early migration and future loosening of total knee and hip prostheses, RSA plays an important role in the development and evaluation of prostheses. However, there have been few RSA studies of the upper limb, and the value of RSA of the upper limb is not yet clear. We therefore performed a systematic review to investigate the accuracy and precision of RSA of the upper limb. Patients and methods - PRISMA guidelines were followed and the protocol for this review was published online at PROSPERO under registration number CRD42016042014. A systematic search of the literature was performed in the databases Embase, Medline, Cochrane, Web of Science, Scopus, Cinahl, and Google Scholar on April 25, 2015 based on the keywords radiostereometric analysis, shoulder prosthesis, elbow prosthesis, wrist prosthesis, trapeziometacarpal joint prosthesis, humerus, ulna, radius, carpus. Articles concerning RSA for the analysis of early migration of prostheses of the upper limb were included. Quality assessment was performed using the MINORS score, Downs and Black checklist, and the ISO RSA Results - 23 studies were included. Precision values were in the 0.06-0.88 mm and 0.05-10.7° range for the shoulder, the 0.05-0.34 mm and 0.16-0.76° range for the elbow, and the 0.16-1.83 mm and 11-124° range for the TMC joint. Accuracy data from marker- and model-based RSA were not reported in the studies included. Interpretation - RSA is a highly precise method for measurement of early migration of orthopedic implants in the upper limb. However, the precision of rotation measurement is poor in some components. Challenges with RSA in the upper limb include the symmetrical shape of prostheses and the limited size of surrounding bone, leading to over-projection of the markers by the prosthesis. We recommend higher adherence to RSA guidelines and encourage investigators to publish long-term follow-up RSA studies.
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Affiliation(s)
- Bart Ten Brinke
- Department of Orthopaedic Surgery, Amphia Ziekenhuis, Breda;,Department of Orthopaedic Surgery, Reinier de Graaf Hospital, Delft;,Correspondence:
| | | | - Koen L M Koenraadt
- FORCE Foundation, Department of Orthopaedic Surgery, Amphia Ziekenhuis, Breda
| | - Denise Eygendaal
- Department of Orthopaedic Surgery, Amphia Ziekenhuis, Breda;,Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands
| | - Gerald A Kraan
- Department of Orthopaedic Surgery, Reinier de Graaf Hospital, Delft
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Viveen J, Prkic A, Koenraadt KLM, Kodde IF, The B, Eygendaal D. Clinical and radiographic outcome of revision surgery of total elbow prosthesis: midterm results in 19 cases. J Shoulder Elbow Surg 2017; 26:716-722. [PMID: 28089825 DOI: 10.1016/j.jse.2016.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 10/26/2016] [Accepted: 10/26/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND The aim of this study is to report on the midterm outcomes and complications of revision surgery of total elbow arthroplasty. METHODS All patients who had undergone total elbow arthroplasty revision surgery between 2009 and 2014 with semiconstrained total elbow prostheses were prospectively enrolled in the study. Records were reviewed for demographic data; baseline measurements; and several follow-up assessments including the Mayo Elbow Performance Score (MEPS), visual analog scale (VAS) score for pain, Oxford Elbow Score, range of motion, satisfaction, and radiographs. RESULTS A total of 19 revision arthroplasties were included. At a mean follow-up of 57 months, there had been 1 rerevision and 2 removals. One patient was excluded from follow-up because of confounding comorbidity. At last follow-up, MEPS values and VAS pain scores both improved (P < .01). The rate of combined good and excellent results on the MEPS was 53%. The mean VAS scores for pain at rest and with activity were 2 and 4, respectively. Fair results for the Oxford Elbow Score were reported, with a mean score of 28 points. Range of motion improved to an average flexion-extension arc of 108° (P < .01), and the pronation-supination arc improved to an average of 123° (P < .01). All elbows were stable at last follow-up (P < .01). Radiographs showed nonprogressive osteolysis around the prosthesis in 3 cases (19%) and suspicion of loosening in 1 (6%). In 11 patients postoperative complications occurred. Of 15 patients, 13 (87%) were satisfied with the result of the revision procedure. CONCLUSION Revision of total elbow prostheses leads to satisfactory results, less pain, and better elbow function. This procedure is related to a relatively high complication rate.
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Affiliation(s)
- Jetske Viveen
- Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands.
| | - Ante Prkic
- Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands
| | - Koen L M Koenraadt
- Foundation for Orthopedic Research, Care & Education, Amphia Hospital, Breda, The Netherlands
| | - Izaäk F Kodde
- Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands; Department of Orthopaedic Surgery, University of Amsterdam, Amsterdam-Zuidoost, The Netherlands
| | - Bertram The
- Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands
| | - Denise Eygendaal
- Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands; Department of Orthopaedic Surgery, University of Amsterdam, Amsterdam-Zuidoost, The Netherlands
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10
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de Vos MJ, Wagener ML, Hannink G, van der Pluijm M, Verdonschot N, Eygendaal D. Short-term clinical results of revision elbow arthroplasty using the Latitude total elbow arthroplasty. Bone Joint J 2016; 98-B:1086-92. [DOI: 10.1302/0301-620x.98b8.35025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 11/11/2015] [Indexed: 11/05/2022]
Abstract
Aims Revision total elbow arthroplasty (TEA) is often challenging. The aim of this study was to report on the clinical and radiological results of revision arthroplasty of the elbow with the Latitude TEA. Patients and Methods Between 2006 and 2010 we used the Latitude TEA for revision in 18 consecutive elbows (17 patients); mean age 53 years (28 to 80); 14 women. A Kudo TEA was revised in 15 elbows and a Souter-Strathclyde TEA in three. Stability, range of movement (ROM), visual analogue score (VAS) for pain and functional scores, Elbow Functional Assessment Scale (EFAS), the Functional Rating Index of Broberg and Morrey (FRIBM) and the Modified Andrews’ Elbow Scoring System (MAESS) were assessed pre-operatively and at each post-operative follow-up visit (six, 12 months and biennially thereafter). Radiographs were analysed for loosening, fractures and dislocation. The mean follow-up was 59 months (26 to 89). Results The ROM of the elbow did not improve significantly. The mean EFAS and MAESS scores improved significantly six months post-operatively (18.6 points, standard deviation (sd) 7.7; p = 0.03 and 28.8 points, sd 8.6; p = 0.006, respectively) and continued to improve slightly or reached a plateau. The mean pain scores at rest (Z = -3.2, p = 0.001) and during activity (Z = -3.2, p = 0.001), and stability (Z = -3.0, p = 0.003) improved significantly six months post-operatively. Thereafter scores continued to improve slightly or a plateau was reached. There were no signs of loosening. Conclusion Revision surgery using the Latitude TEA results in improvement of functionality, reduced pain and better stability of the elbow. Improvement of ROM of the elbow should not be expected. Cite this article: Bone Joint J 2016;98-B:1086–92.
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Affiliation(s)
- M. J. de Vos
- Ter Gooi Hospital, Department
of Orthopaedics, PO Box 10016, 1201DA
Hilversum, The Netherlands
| | - M. L. Wagener
- Rijnstate Hospital, PO
Box 9555, 6800TA Arnhem, The
Netherlands
| | - G. Hannink
- Radboud University Medical Center, Orthopaedic
Research Lab, PO Box 9101, 6500HB
Nijmegen, The Netherlands
| | | | - N. Verdonschot
- Radboud University Medical Center, Orthopaedic
Research Lab, PO Box 9101, 6500HB Nijmegen and Laboratory for Biomechanical
Engineering, University of Twente, PO
Box 217, 7500AE Enschede, The
Netherlands
| | - D. Eygendaal
- Amphia Hospital, Department
of Orthopaedics, PO Box 90157, 4800RL Breda, The
Netherlands AMC Hospital, Meibergdreef 91105AZ,
Amsterdam, The Netherlands
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11
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Degreef I. Elbow arthroplasty: where are we today? A narrative review. Acta Chir Belg 2016; 116:73-80. [PMID: 27385293 DOI: 10.1080/00015458.2016.1147246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background The elbow joint is a complex compound articulation, with a linking role within the upper limb kinematics. Its hinge function allows for proper placement of our working instrument (the hand) in the space surrounding us, directed by the shoulder joint. Both reliable mobility and stability are essential elements to allow for consistent bridging of the distance we aim to achieve in common daily activities. Sufficient flexion and extension are required to ensure both the patients' independence and the dignity. Next to the hinge, a radio-ulnar rotation with precise co-operation of forearm and wrist spin enhances the linking function with accurate precision instrument manipulation. Arthritis of the elbow joint or cubarthritis, whether primary or secondary, may not be as highly prevalent as hip or knee arthritis, but its impact on daily live certainly cannot be underestimated. Methods Current treatment options for failing cubarthritis are reviewed. Results Surgical techniques to reconstruct or replace the elbow joint are currently increasingly efficient with mounting long-term outcome reports. Debridement techniques including open or arthroscopic Outerbridge-Kashiwaghi procedure often delays joint replacement. Implants for joint arthroplasty focus on the ulna-humeral joint mostly with semi-constrained linked techniques, but there is a trend towards total joint replacement including the radiocapitellar joint. Conclusion In this independent review article, elbow joint failure due to cubarthritis and an overview of its current state-of-the-art orthopaedic treatment algorithm is presented, with its indications, advantages, risks and outcome.
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