Revision Arthroplasty in the Challenging Elbow

Xiao, Ryan; Model, Zina; Kim, Jaehon M.; Chen, Neal C.

doi:10.1016/j.hcl.2023.03.001

Cited by 3 publications

(3 citation statements)

References 67 publications

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“…Traditional revision surgery requires removal of the prosthesis, which may cause greater trauma and serious complications to the patient. 14 In this study, 3D printing technology was employed for the management of revision surgery following hinge failure resulting from fracture in tumor‐type elbow prostheses. Considering the absence of cement stem loosening in the humerus and ulnar bone marrow, as well as the lack of fracture and osteolysis around the prosthesis.…”

Section: Discussionmentioning

confidence: 99%

“…To date, there is a paucity of literature documenting the techniques employed in revision surgery for fractures of elbow prostheses. Traditional revision surgery requires removal of the prosthesis, which may cause greater trauma and serious complications to the patient 14 . In this study, 3D printing technology was employed for the management of revision surgery following hinge failure resulting from fracture in tumor‐type elbow prostheses.…”

Section: Discussionmentioning

confidence: 99%

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Using 3D Printing Technology to Design Split‐Piece Sleeve Prosthesis in the Revision Surgery of Tumor‐Type Total Elbow Prosthetic Fractures: A Case Report

Zhai,

Zheng,

et al. 2024

Orthopaedic Surgery

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BackgroundRevision of tumor‐type prosthetic fractures is very challenging in clinical work. Traditional repair methods may not be able to meet the needs of complex cases or cause greater bone damage. Therefore, more effective and reliable solutions need to be found.Case PresentationThis study presents a novel revision technique for managing fractures of tumor‐type total elbow prostheses. A 57‐year‐old female patient was diagnosed with a left distal humeral bone tumor accompanied by pathological fracture and underwent customized tumor‐type total elbow prosthesis arthroplasty. After 5 years, she experienced pain and encountered difficulty in flexing the left elbow while lifting heavy objects. The X‐ray examination revealed a fracture of the distal humeral prosthesis. As a response, the elbow joint was initially explored, and the damaged component of the prosthesis was extracted. Subsequently, we utilized 3D printing technology to design a split‐piece sleeve prosthesis and effectively restored the fractured left distal humerus implant. During the 2‐year follow‐up, The X‐ray demonstrated satisfactory positioning of the prosthesis, which remained securely affixed without any indications of loosening. The Mayo Elbow Performance Score (MEPS) reached 80 points, the Musculoskeletal Tumor Society (MSTS) attained a score of 28 points, and the range of motion of the elbow was measured between 25° and 110°, revealing favorable functional outcomes.ConclusionThe utilization of a 3D printed split‐piece sleeve prosthesis presents a viable clinical treatment strategy for addressing fractures in tumor‐type elbow prostheses.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Using 3D Printing Technology to Design Split‐Piece Sleeve Prosthesis in the Revision Surgery of Tumor‐Type Total Elbow Prosthetic Fractures: A Case Report

Zhai,

Zheng,

et al. 2024

Orthopaedic Surgery

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show abstract

“…To date, few studies have concentrated on the treatment methods using revision surgery for fractured elbow prostheses. Traditional revision surgery requires removal of the prosthesis, which may cause greater trauma and serious complications to the patient 10 . According to the concept of limited revision, in the present study, the fracture location of the prosthesis was rst determined using digital orthopedics and a 3D model of the original prosthesis's broken end was printed, thereby designing and producing a split-piece sleeve with a thickened design at the fracture point.…”

Section: Discussionmentioning

confidence: 99%

Application of 3D printing-designed split-piece sleeve prosthesis in the revision surgery of tumor-type total elbow prosthetic fractures: a case report

Zhai,

Zheng,

et al. 2023

Preprint

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Objective This study aimed to assess the application of split sleeve technology in the revision surgery of tumor-type total elbow prosthetic fractures. Case report This retrospective study included a 57-year-old female patient who suffered from left upper arm pain and limited activity for half a month due to trauma. She was admitted to the 960th Hospital of the People’s Liberation Army (Jinan, China) on October 14, 2016. The histopathological type of tumor was hemangioma with active chondroblast proliferation. Following the diagnosis of a bone tumor in the left distal humerus, along with a pathological fracture, customized tumor-type total elbow prosthetic replacement was carried out due to extensive bone destruction in the affected area. After 5 years, she developed left elbow pain and difficulty in flexing the elbow when lifting heavy objects. X-ray showed that the lateral parts of the connection between the left distal humerus and the ulnar prosthesis were displaced. The patient was admitted to the hospital with the diagnosis of prosthetic fracture. Given the absence of bone cement stem loosening in the humeral and ulnar bone marrow, as well as the absence of fractures or osteolysis around the prosthesis, opting for a complete prosthesis revision would result in more substantial bone damage. Hence, the decision was made to retain the original prosthesis. With the assistance of three-dimensional (3D) printing technology, a split-piece sleeve prosthesis at the broken end hinge was designed, and the left distal humeral prosthesis was subsequently revised with a split-piece sleeve total elbow prosthesis at the broken end. Outcome and Follow-up The surgical process went smoothly, and the prosthesis was accurately installed according to the preoperative design. The patient recovered well after the surgery and the incision was healed in the first stage. During the 2 year follow-up, the elbow split socket prosthesis was firmly fixed without loosening. At the last follow-up, the Mayo Elbow Performance Score (MEPS) was 80 points, and the range of motion of the elbow was 25°～110°. Conclusion The split sleeve technique possesses the advantages of low surgical difficulty, limited trauma, and definite clinical efficacy in the revision surgery of tumor-type total elbow prosthetic fractures.

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Cortical windows for implant and cement removal during revision total elbow arthroplasty

Luciani,

Ozdag,

Koshinski

et al. 2024

JSES International

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Revision Arthroplasty in the Challenging Elbow

Cited by 3 publications

References 67 publications

Using 3D Printing Technology to Design Split‐Piece Sleeve Prosthesis in the Revision Surgery of Tumor‐Type Total Elbow Prosthetic Fractures: A Case Report

Using 3D Printing Technology to Design Split‐Piece Sleeve Prosthesis in the Revision Surgery of Tumor‐Type Total Elbow Prosthetic Fractures: A Case Report

Application of 3D printing-designed split-piece sleeve prosthesis in the revision surgery of tumor-type total elbow prosthetic fractures: a case report

Cortical windows for implant and cement removal during revision total elbow arthroplasty

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