Impaction Grafting in Revision Total Elbow Arthroplasty

Loebenberg, Mark I.; Adams, Robert A.; O’Driscoll, Shawn W.; Morrey, B.F.

doi:10.2106/jbjs.b.00038

Cited by 61 publications

(26 citation statements)

References 13 publications

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“…However, there was a high incidence of complications, including intraoperative fractures and radial or ulnar nerve dysfunction. More recent studies have documented a high success rate with revision techniques used in the presence of bone loss, including cortical strut allografts, impaction grafting and allograft-prosthetic composites [33, 34, 36, 37]. In general terms, allograft-prosthetic composites have provided inferior results compared to other techniques.…”

Section: Revision Surgerymentioning

confidence: 99%

Total Elbow Arthroplasty

Sánchez-Sotelo¹

2011

TOORTHJ

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Total elbow arthroplasty has continued to evolve over time. Elbow implants may be linked or unlinked. Unlinked implants are attractive for patients with relatively well preserved bone stock and ligaments, but many favor linked implants, since they prevent instability and allow replacement for a wider spectrum of indications. Inflammatory arthropathies such as rheumatoid arthritis represent the classic indication for elbow arthroplasty. Indications have been expanded to include posttraumatic osteoarthritis, acute distal humerus fractures, distal humerus nonunions and reconstruction after tumor resection. Elbow arthroplasty is very successful in terms of pain relief, motion and function. However, its complication rate remains higher than arthroplasty of other joints. The overall success rate is best for patients with inflammatory arthritis and elderly patients with acute distal humerus fractures, worse for patients with posttraumatic osteoarthritis. The most common complications of elbow arthroplasty include infection, loosening, wear, triceps weakness and ulnar neuropathy. When revision surgery becomes necessary, bone augmentation techniques provide a reasonable outcome.

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Section: Revision Surgerymentioning

confidence: 99%

Total Elbow Arthroplasty

Sánchez-Sotelo¹

2011

TOORTHJ

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“…1,11,16 Patients were placed supine with the operative extremity over the chest. A tourniquet and posterior approach were used in all cases.…”

Section: Clinical Datamentioning

confidence: 99%

“…Several studies have investigated the mechanisms of implant failure. [7][8][9][10][11]22 Furthermore, revision total elbow arthroplasty has undergone an evolution from its inception to the present day. The initial results of total elbow revision were discouraging, but more recent reports have documented improved outcomes.…”

mentioning

confidence: 99%

“…The initial results of total elbow revision were discouraging, but more recent reports have documented improved outcomes. 1,[11][12][13]16,18,19,21 Revision procedures continue to be fraught with risk and difficulty because of multiple prior exposures causing extensive scarring with loss of normal soft-tissue planes, insufficient bone stock, difficulty with cement removal, and the presence of previous mechanical or septic complications. Chief among these concerns during revision of the humeral component is the radial nerve, which is often intimately involved with the surgical field.…”

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confidence: 99%

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Radial nerve palsy after humeral revision in total elbow arthroplasty

Throckmorton¹,

Zarkadas²,

Sánchez-Sotelo³

et al. 2011

Journal of Shoulder and Elbow Surgery

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“…Surgery for a loosened component before periprosthetic fracture will require revision of the component, as well as possible impaction bone grafting for intramedullary bone loss. 8 Unicortical locking plates and screws may also secure fixation (Fig. 5).…”

Section: Pearls and Pitfallsmentioning

confidence: 99%