Surgical Exposures for Total Elbow Arthroplasty

Horneff, John G.; Ramsey, Matthew L.

doi:10.5435/jaaos-d-17-00916

Cited by 10 publications

(4 citation statements)

References 31 publications

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“…Several approaches have been reported to deal with the triceps and expose the elbow joint during TEA. Each approach provides variation in the amount of exposure, technical difficulty, and complication profile 18,53,54 . The approaches described for TEA fall into two major categories: triceps off, in which the triceps is detached from the olecranon, and triceps on or triceps‐preserving, in which most of the triceps insertion on the olecranon is kept intact 27 …”

Section: Discussionmentioning

confidence: 99%

“…Each approach provides variation in the amount of exposure, technical difficulty, and complication profile. 18,53,54 The approaches described for TEA fall into two major categories: triceps off, in which the triceps is detached from the olecranon, and triceps on or triceps-preserving, in which most of the triceps insertion on the olecranon is kept intact. 27 Many posterior approaches for TEA have been described in order to avoid triceps weakness and to improve extension strength.…”

Section: Approaches Of Teamentioning

confidence: 99%

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Clinical and Radiographic Outcomes of Total Elbow Arthroplasty Using a Semi‐constrained Prosthesis with a Triceps‐preserving Approach over a Minimum Follow‐up Period of 4 Years

Zhang¹,

Xiang²,

Yang³

et al. 2023

Orthopaedic Surgery

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ObjectiveComplications related to triceps after total elbow arthroplasty (TEA) have become a major surgical concern. The triceps‐preserving approach has the advantage of not disturbing the insertion of triceps but is disadvantaged by the reduced exposure of the elbow joint. The aim of this study was to investigate the clinical and radiological outcomes of TEA with a triceps‐preserving approach and to compare the outcomes of TEA to treat arthropathy with that of TEA to treat acute distal humerus fracture.MethodsFrom January 2010 to December 2018, 23 patients undergoing primary TEAs were retrospectively reviewed with a mean follow‐up time of 92.6 months (range, 52–136 months). Each TEA was performed using the triceps‐preserving approach with a semi‐constrained Coonrad–Morrey prosthesis. Patient demographics, range of motion (ROM), pain visual analogue scale (VAS), and triceps strength (Medical Research Council [MRC] scale) were compared before and after surgery. The Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiographic outcome, and complications were evaluated at follow‐up.ResultsIn total, seven males and 16 females were included in this study, with a mean age of 66.1 years (range:46–85 years). By the last follow‐up, pain had been significantly relieved in all patients. The average MEPS in the arthropathy group and fracture group were 90.8 ± 10.3 points (range: 68–98 points) and 91.7 ± 0.4 (range: 76–100 points), respectively. The average DASH of the arthropathy group and fracture group was 37.3 ± 18.8 points (range: 18–52 points) and 38.4 ± 20.1 (range: 16–60 points). At the last follow‐up after surgery, the mean flexion arcs in the arthropathy group and fracture group were 100.4° ± 24.1° and 97.8° ± 28.1°, respectively. The mean pro‐supination arcs in the arthropathy group and fracture group were 142.4° ± 15.2° and 139.2° ± 17.5°, respectively. There were no significant differences in clinical outcomes between the two groups (P ≥ 0.05). Triceps strength was normal (MRC grade V) in 15 elbows and good in eight elbows. None of the cases experienced weakness of the triceps strength, infection, periprosthetic fractures, or prosthesis breakage.ConclusionsThe clinical and radiographical outcomes of TEA with the triceps‐preserving approach were satisfactory in patients with distal humerus fracture, osteoarthritis and rheumatoid arthritis.

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Section: Discussionmentioning

confidence: 99%

Section: Approaches Of Teamentioning

confidence: 99%

Clinical and Radiographic Outcomes of Total Elbow Arthroplasty Using a Semi‐constrained Prosthesis with a Triceps‐preserving Approach over a Minimum Follow‐up Period of 4 Years

Zhang¹,

Xiang²,

Yang³

et al. 2023

Orthopaedic Surgery

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“…Therefore, the handling of the triceps tendon during the approach continues to evolve as well. 53 Triceps turndown, 54,55 triceps splitting, 56 triceps reflecting, and triceps-sparing 53,[57][58][59][60] approaches have also been introduced in the literature. The selection of the surgical exposure practically relies on the surgeon's preference and experience.…”

Section: Postoperative Managementmentioning

confidence: 99%

Surgical management for primary osteoarthritis of the elbow

Kwak

Jeon

2021

J Orthop Surg (Hong Kong)

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The objective of this review is to summarize the surgical options for primary osteoarthritis of the elbow, reported clinical outcomes, and suggested indications in previous literatures. The surgical management of primary elbow arthritis has evolved because of an improved understanding of pathologic mechanisms and manifestations as well as the development of novel surgical techniques and devices. Osteocapsular arthroplasty (OCA), elbow debridement, distraction arthroplasty, and total elbow arthroplasty (TEA) have been employed for managing elbow osteoarthritis. Elbow debridement and OCA can be helpful in most cases of symptomatic elbow arthritis. TEA is usually recommended for end-stage arthritis in elderly patients after prosthetic implants have been in place for long periods or after complications. Distraction arthroplasty might find a place in the treatment of younger, active patients with end-stage arthritis.

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“…A artroplastia total do cotovelo surgiu em meados de 1970 como procedimento restrito às doenças reumáticas avançadas 1,2 . É raramente realizada quando comparada à artroplastia de joelho e quadril, sendo preconizado sua abordagem por cirurgiões experientes em centros de referência 3 .…”

Section: Introductionunclassified

Artroplastia total no tratamento da sequela pós-traumática do cotovelo

Farias,

Castro,

Tanaka

et al. 2024

RTO

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A artroplastia total do cotovelo foi criada em meados de 1970 para tratamento da doença reumatoide avançada. Com o melhor desenvolvimento da técnica cirúrgica e dos implantes outras indicações surgiram: fraturas agudas do úmero distal em idosos, sequelas pós traumáticas, instabilidade disfuncional, reconstrução tumoral e osteoartrose primária. Todavia, são crescentes os casos de complicações e as taxas de revisões cirúrgicas. Os desafios atuais da artroplastia do cotovelo são: as perdas ósseas que exigem construções de revisão melhoradas e o manejo em pacientes jovens de alta demanda que tendem a evoluir com desfechos menos favoráveis. Apresentaremos um relato de caso de um paciente feminino, 42 anos, com sequela de fratura do úmero distal direito há 7 anos que foi tratada com artroplastia total do cotovelo

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Surgical Exposures for Total Elbow Arthroplasty

Cited by 10 publications

References 31 publications

Clinical and Radiographic Outcomes of Total Elbow Arthroplasty Using a Semi‐constrained Prosthesis with a Triceps‐preserving Approach over a Minimum Follow‐up Period of 4 Years

Clinical and Radiographic Outcomes of Total Elbow Arthroplasty Using a Semi‐constrained Prosthesis with a Triceps‐preserving Approach over a Minimum Follow‐up Period of 4 Years

Surgical management for primary osteoarthritis of the elbow

Artroplastia total no tratamento da sequela pós-traumática do cotovelo

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