Aims. The aim of this study is to report the implant survival and factors associated with revision of
Aims. There are concerns regarding complications and longevity of
Aims. Arthroplasty is being increasingly used for the management of distal humeral fractures (DHFs) in elderly patients. Arthroplasty options include
Aims. The aims of this study were to validate the outcome of
Aims. The aim of this meta-analysis was to compare the outcome of
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). 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.Aims
Patients and Methods
To prevent insufficiency of the triceps after
total elbow arthroplasty, we have, since 2008, used a triceps-sparing ulnar
approach. This study evaluates the clinical results and post-operative
alignment of the prosthesis using this approach. We reviewed 25 elbows in 23 patients. There were five men and
18 women with a mean age of 69 years (54 to 83). There were 18 elbows
with rheumatoid arthritis, six with a fracture or pseudoarthrosis
and one elbow with osteoarthritis. Post-operative complications included one intra-operative fracture,
one elbow with heterotopic ossification, one transient ulnar nerve
palsy, and one elbow with skin necrosis, but no elbow was affected
by insufficiency of the triceps. Patients were followed for a mean of 42 months (24 to 77). The
mean post-operative Japanese Orthopaedic Association Elbow Score
was 90.8 (51 to 100) and the mean Mayo Elbow Performance score 93.8
(65 to 100). The mean post-operative flexion/extension of the elbow
was 135°/-8°. The Manual Muscle Testing score of the triceps was
5 in 23 elbows and 2 in two elbows (one patient). The mean alignment
of the implants examined by 3D-CT was 2.8° pronation (standard deviation
( The triceps-sparing ulnar approach allows satisfactory alignment
of the implants, is effective in preventing post-operative triceps
insufficiency, and gives satisfactory short-term results. Cite this article: 2015;97-B:1096–1101.
Aims. The aims of this study were to identify and evaluate the current literature examining the prognostic factors which are associated with failure of
Open debridement and Outerbridge and Kashiwagi debridement arthroplasty (OK procedure) are common surgical treatments for elbow arthritis. However, the literature contains little information on the long-term survivorship of these procedures. The purpose of this study was to determine the survivorship after elbow debridement techniques until conversion to
Open debridement and Outerbridge and Kashiwagi debridement arthroplasty (OK procedure) are common surgical treatments for elbow arthritis. However, the literature contains little information on the long-term survivorship of these procedures. The purpose of this study was to determine the survivorship after elbow debridement techniques until conversion to
This study reports our experience with
Between 1993 and 2002, 58 GSB III
Between September 1993 and September 1996, we performed 34 Kudo 5
Ulnar neuropathy presents as a complication in 5% to 10% of
Total Elbow Replacements are indicated for pain and disability in patients with rheumatoid and osteoarthritis of the elbow. The quality of the cementation has been specifically studied and shown to be directly related to the clinical outcome and implant survival. Aim. The aim of our study is to radiologically assess and grade the cementation around the components following
We reviewed 20 patients who had undergone a Coonrad-Morrey
Aim. Infections after
Aim. The primary aim of this retrospective study was to identify the
incidence of heterotopic ossification (HO) following elective and
trauma elbow arthroplasty. The secondary aim was to determine clinical
outcomes with respect to the formation of heterotopic ossification. Patients and Methods. A total of 55
Aims: To review the results from a series of GSB III
Aims: To review the results from a series of GSB III
Reconstruction of deficient bone stock during
The purpose of this study was to assess the long-term results (more than ten years) of two types of cemented ulnar component with type-5 Kudo
Heterotopic Ossification (HO) is a known complication that can arise after
The purpose of this study is to report our experience with revision of
We present the early results of 36 primary
We present the outcome of 47 Souter-Strathclyde replacements of the elbow with a mean follow-up of 82 months (12 to 129). The clinical results were assessed using a condition-specific outcome measure. The mean total score (maximum 100) before the operation was 47.21 and improved to 79.92 (p <
0.001). The mean pain score (maximum 50) improved from 21.41 to 46.70 (p <
0.001) and the mean functional component of the score (maximum 30) from 11.19 to 18.65 (p <
0.001). There was negligible change in the score for the range of movement although a significant improvement in mean flexion from 124° to 136° was noted (p <
0.001). Revision surgery was required in four patients, for dislocation, wound dehiscence and early infection in one, late infection in two and aseptic loosening in one. The cumulative survival was 75% at nine years for all causes of failure and 97% at ten years for aseptic loosening alone. Our study demonstrates the value of the Souter-Strathclyde
There have been few reports in the literature of
Aim: To study the role of
Although it is generally accepted that revision
Although it is generally accepted that revision
We assessed the long-term results of 58 Souter-Strathclyde
We reviewed 25 patients with rheumatoid arthritis who had failure of 26 primary
The aim of this study was to assess the long-term results of the Kudo type-5 total elbow prosthesis and compare the results of two types of cemented ulnar components. The Kudo type-5 unlinked total elbow prosthesis (Biomet UK Ltd, Bridgend Wales) was developed in 1993. The stem of humeral component is porous-coated with a plasma spray of titanium alloy for cementless use. The ulnar component may be metal-backed with a porous-coated stem or polyethylene alone; the latter designed mainly for cement use. A metal-backed type without a porous-coated stem designed for cement use also came into being after 2003. Between 1993 and 2010, the Kudo type-5
Between 1982 and 1997, 403 consecutive patients (522 elbows) with rheumatoid arthritis underwent Souter-Strathclyde
Implant designs for hip and knee arthroplasty have undergone a continual improvement process, but development of implants for
This study reviews the predisposing features, the clinical, and laboratory findings at the time of diagnosis and the results of single-stage revision of prosthetic replacement of the elbow for infection. Deep infection occurred in six of 305 (1.9%) primary
We analysed the outcome of the Coonrad-Morrey
We examined the effects of previous resection of the radial head and synovectomy on the outcome of subsequent
To show the role and effectiveness of semi-constrained
Aim:. To investigate the incidence of post-operative ulna nerve symptoms in
Distal humeral fractures are difficult fractures to treat. In the elderly population the problems are compounded by gross comminution and osteoporosis. Concurrent presence of rheumatoid arthritis makes the problem more difficult. Open reduction and internal fixation of such fractures have been shown to give poor results.
Summary Statement. Discovery system produced effective functional improvement in both primary and revision
Aims. Revision
We report our experience of staged revision surgery
for the treatment of infected
Background. The quest for the perfectly designed elbow prosthesis continues as instability and loosening remain the foremost reasons for the failure of
40 linked
This is a retrospective review of the results of the Acclaim
Background: Total elbow prostheses are broadly classified into linked and the unlinked categories. We have looked at long-term results of unlinked Kudo 5
Introduction. Primary
We have carried out a retrospective review of 11 Souter-Strathclyde primary
Aim: 40 linked
Purpose: Aseptic loosening is one of the leading causes of failure in
We determined the short-term clinical outcome
and migration within the bone of the humeral cementless component
of the Instrumented Bone Preserving (IBP) total elbow replacement
in a series of 16 patients. There were four men and 12 women with
a mean age at operation of 63 years (40 to 81). Migration was calculated
using radiostereometric analysis. There were no intra-operative
complications and no revisions. At two-year follow-up, all patients
showed a significant reduction in pain and functional improvement
of the elbow (both p <
0.001). Although ten components (63%)
showed movement or micromovement during the first six weeks, 14
(88%) were stable at one year post-operatively. Translation was
primarily found in the proximal direction (median 0.3 mm (interquartile range
(IQR) -0.09 to 0.8); the major rotational movement was an anterior
tilt (median 0.7° (IQR 0.4° to 1.6°)). One malaligned component
continued to migrate during the second year, and one component could
not be followed beyond three months because migration had caused
the markers to break off the prosthesis. This study shows promising early results for the cementless humeral
component of the IBP
Aim. To compare radiological and clinical outcomes between triceps-detaching and triceps-sparing approaches in
Aim. The aim of this study was to report the long-term outcome and
implant survival of the lateral resurfacing elbow (LRE) arthroplasty
in the treatment of elbow arthritis. Patients and Methods. We reviewed a consecutive series of 27 patients (30 elbows) who
underwent LRE arthroplasty between December 2005 and January 2008.
There were 15 women and 12 men, with a mean age of 61 years (25
to 82). The diagnosis was primary hypotrophic osteoarthritis (OA)
in 12 patients (14 elbows), post-traumatic osteoarthritis (PTOA)
in five (five elbows) and rheumatoid arthritis (RA) in ten patients
(11 elbows). The mean clinical outcome scores including the Mayo
Elbow Performance Score (MEPS), the American Shoulder and Elbow
Surgeons elbow score (ASES-e), the mean range of movement and the
radiological outcome were recorded at three, six and 12 months and
at a mean final follow-up of 8.3 years (7.3 to 9.4). A one sample t-test
comparing pre and postoperative values, and survival analysis using
the Kaplan–Meier method were undertaken. Results. A statistically significantly increased outcome score was noted
for the whole group at each time interval. This was also significantly
increased at each time in each of the subgroups (OA, RA, and PTOA).
Implant survivorship was 100%. Conclusion. We found that the LRE arthroplasty, which was initially developed
for younger patients with osteoarthritis, is an effective form of
surgical treatment for a wider range of patients with more severe
degenerative changes, irrespective of their cause. It is therefore
a satisfactory alternative to
We analysed the outcome of the Coonrad-Morrey
Aims. We describe the use of a protocol of irrigation and debridement
(I&
D) with retention of the implant for the treatment of periprosthetic
infection of a
This study investigated the effect of the articulation position on joint load transfer in
We used 11 cadaver elbows and a three-dimensional electromagnetic tracking device to record elbow movements before and after implantation of a 'loose-hinged' elbow prosthesis (modified Coonrad). During simulated active motion there was a maximum of 2.7 degrees (+/- 1.5 degrees) varus/valgus laxity in the cadaver joints. This increased slightly after
Although
We compared the outcome of peri-operative humeral condylar fractures in patients undergoing a Coonrad-Morrey semiconstrained
The Souter-Strathclyde prosthesis was used in 52 revisions of
Introduction. Recently, computer-aided orthopaedic surgery has enabled three dimensional (3D) preoperative planning, navigation systems and patient matched instrument, and they provide good clinical results in total knee arthroplasty. However, the preoperative planning methods and the criteria in
Between 1993 and 1996, we undertook 35 Kudo 5
The treatment of multifragmentary, intra-articular fractures of the distal humerus is difficult, even in young patients with bone of good quality, but is worse in elderly patients who have varying degrees of osteopenia. We have evaluated the functional outcome of primary
To assess the outcome of semi-constrained
Purpose of study:.
The aim of this study was to review the outcome of semi-constrained
Background. Previously, the Coonrad-Morrey elbow system has typically been performed using linked-type
Between 1993 and 1996, 35 Kudo unlinked
Our study examines a group of patients less than fifty years of age who underwent
A 55-year-old woman who was diagnosed as RA (stage, class ) in 1995 had undergone right
INTRODUCTION. Aseptic loosening is the most common failure mode for
Objective. Computed tomography based three-dimensional surgical preoperative planning (3D-planning) has been expanded to achieve more precise placement of knee and hip arthroplasties. However, few reports have addressed the utility of 3D-planning for the
A primary mode of failure for
Correct placement of the total elbow endoprosthesis is a critical factor for the long-term success of an artificial joint. Correct restoration of the centre of rotation is essential for optimal outcome. To evaluate whether surgical navigation has the potential to improve accuracy during
To date there has been only one published series of elbow arthroplasty in patients with Juvenile Idiopathic arthritis. These patients pose particular problems because of the size and variable shape of the humerus and ulna together with the soft tissue contractures and bony erosion which can sometimes be severe. We have reviewed the results of elbow arthroplasty using the unlinked Kudo 5 and the linked Coonrad-Morrey implants which in our practice have different indications dependent upon bone stock and stability. Methods 19
Background.
Purpose of the study: to demonstrate a mechanism of loosening of the Souter-Strathclyde
Purpose: This study evaluated the accuracy of humeral component alignment in
We used survival analysis to evaluate 113 consecutive semiconstrained
Introduction: Treatment and outcome of patients with rheumatoid arthritis and distal humerus fractures is not well established. Methods: Between 1982 and 2002 twenty-four elbows in twenty-two patients (eleven men, eleven women) treated for acute distal humerus fractures were retrospectively reviewed. The average age at time of the fracture was 64 years. Eleven elbows were immediately treated with a
Background: To date there has been only one published series of elbow arthroplasty in patients with Juvenile Idiopathic arthritis. These patients pose particular problems because of the size and variable shape of the humerus and ulna together with the soft tissue contractures and bony erosion which can sometimes be severe. We have reviewed the results of elbow arthroplasty using the unlinked Kudo 5 and the linked Coonrad-Morrey implants which in our practice have different indications dependent upon bone stock and stability. Methods: 19
Purpose: While computer-assisted techniques can improve the alignment of the implant articulation with the native structure, stem abutment in the intramedullary canal may impede achievement of this alignment. In the current study, the effect of a fixed valgus (6 degree) stemmed humeral component on the alignment of navigated
Cobb and Morrey (1997) reported the use of
Background: Total elbow prostheses are broadly classified into linked and the unlinked categories. We have looked at long-term results of unlinked Kudo 5
We conducted a prospective randomised controlled trial to compare functional outcomes, complications and reoperation rates in elderly patients with displaced intra-articular distal humerus fractures treated with open reduction internal fixation (ORIF) or primary semi-constrained
Purpose: Ligaments and osseous constraints are the only static stabilizers in a healthy elbow. Following arthroplasty, the use of semi-constrained, or linked, implants provides a potential third static stabilizer. However, this constraint may increase loading on the prosthesis, and hence accelerate polyethylene wear. The presence of competent collateral ligaments and the radial head would be expected to improve elbow stability and decrease loading on the ulnohumeral articulation. This in vitro study determined the effects of the collateral ligaments, radial head, and implant linkage on kinematics and wear-inducing loads in
We review our experience of Coonrad-Morrey total elbow arthroplasty
(TEA) for fractures of the distal humerus in non-rheumatoid patients
with a minimum of ten years follow-up. TEA through a triceps splitting approach was peformed in 37 non-rheumatoid
patients for a fracture of the distal humerus between 1996 and 2004.
One patient could not be traced and 17 had died before the tenth
anniversary of their surgery. This left 19 patients with a minimum
follow-up of ten years to form the study group. Of these, 13 patients
were alive at the time of final review. The other six had died,
but after the tenth anniversary of their elbow arthroplasty. Their
clinical and radiological data were included in the study. Aims
Patients and Methods
Introduction.
We studied 11 patients (14 elbows) with gross rheumatoid deformity of the elbow, treated by total arthroplasty using the Kudo type-5 unlinked prosthesis, and who were evaluated between five and 11 years after operation. Massive bone defects were augmented by autogenous bone grafts. There were no major complications such as infection, subluxation or loosening. In most elbows relief from pain and stability were achieved. The results, according to the Mayo Elbow Performance Score, were excellent in eight, good in five and fair in one. In most elbows there was minimal or no resorption of the grafted bone. There were no radiolucent lines around the stems of the cementless components. This study shows that even highly unstable rheumatoid elbows can be replaced successfully using an unlinked prosthesis, with augmentation by grafting for major defects of bone.