PURPOSE: To analyze clinical presentation and results of the treatment of periprosthetic fractures occurring after total elbow replacement (TER). MATERIALS AND METHODS: Eleven patients who had periprosthetic fractures after TER were examined. The locations and the causes of periprosthetic fractures were evaluated. The periprosthetic fractures were classified using Mayo classification. Stable fractures were treated conservatively, and unstable fractures were treated by open reduction and internal fixation. Revision operation was conducted if implant loosening was observed. End results after treatment were evaluated based on Mayo elbow performance score (MEPS) and radiologic examinations. RESULTS: Most fractures occurred at the humeral site(82%), and Type B2 periprosthetic fracture was most frequently observed(64%). Radiographic union was observed at a mean of 26 weeks after the treatment. No statistically significant differences were observed between preoperative and postoperative elbow active motions. According to the MEPS, the results were rated as excellent in three patients, good in five, fair in one and poor in two. CONCLUSION: A periprosthetic fracture after TER likely occurrs at humeral site and it is highly related with loosening of the implant. Although union tends to be delayed and complications occur frequently, relatively fair results can be obtained with appropriate treatment.
Arthroplasty, Replacement, Elbow ; Elbow ; Humans ; Periprosthetic Fractures

Arthroplasty, Replacement, Elbow ; Elbow Joint ; injuries ; surgery ; Fracture Fixation ; Humans

Total elbow arthroplasty is a relatively rare procedure compared with total knee or total hip arthroplasty. Total elbow arthroplasty for bony ankylosis is even rarer, and the results are often unsatisfactory. We report a patient who gained good mobility of the elbow after total elbow arthroplasty for the treatment of fractured arthrodesis site with which the patient had lived with for 12 years.
Ankylosis ; Arthrodesis* ; Arthroplasty* ; Arthroplasty, Replacement, Hip ; Elbow* ; Humans ; Knee

Arthroplasty, Replacement ; Elbow Joint ; injuries ; surgery ; Humans ; Joint Instability ; therapy ; Tennis Elbow ; therapy

So many modalities have been suggested for the treatment of servere pain and ankylosis of the elbow with destruction of the articular surfaces. Among them, two major methods which have been widely used are resection arthroplasty and prosthetic replacement arthroplasty. However prosthetic replacement arthroplasty has some problems. Its indications are limited in the elderly inactive subjects. And there have been many kinds of complications including loosening and infection. Also, resection arthroplasty in now rarely indicated due to severe instability. From July 1980 to July 1987, we tried distraction arthroplasty in 8 cases of elbow with severe destruction of its articular surfaces, mainly in the young active persons. The average follow-up period was 45 months. The effect of distraction arthroplasty on relief of pain was not remarkable. The average increase in ROM, including that of one reankylosed elbow, was 51 ±22 degrees in flexion-extension and 48 ±23 degrees in pronstion-supinstion. No deep wound infection and instability which was main complication of resection arthroplasty were observed with our method of distraction arthroplasty. On the basis of functional results, the the results were excellent in 4, good in 1, fair in 2 and poor in 1 cases. In conclusion, distraction arthroplasty of the elbow can be one of the of effective methods reconstruction for the young active patients with the destruction of the elbow, if they are intelligent and motivated.
Aged ; Ankylosis ; Arthroplasty ; Arthroplasty, Replacement ; Elbow ; Follow-Up Studies ; Humans ; Methods ; Wound Infection

PURPOSE: Few studies have compared the outcomes, complications and revision rate of a total elbow replacement (TER) prosthetic design. This study examined a series of patients with semiconstrained and unconstrained total elbow replacements (TER) and evaluated them for any functional differences, complications and revision rates that might be attributable to the prosthetic design. MATERIALS AND METHODS: A total 78 cases of primary TER was performed in 71 patients. Their mean age at TER was 54 years. The causes of TER were rheumatoid arthritis in 42, post-traumatic arthritis and osteoarthritis 24 and 5 patients, respectively. Unconstrained and semiconstrained TER was employed in 35 and 43 cases, respectively. The end results of TER by the Mayo elbow performance score (MEPS), their elbow range of motion before and after surgery, their complications and revision rates after an average 13 year follow-up were evaluated. RESULTS: The MEPS was improved from 33 points pre-operatively to 87 points post-operatively (p<0.001). Active flexion-extension elbow motions were also improved markedly from 27degrees-86degrees pre-operatively to 16degrees-128degrees postoperatively (p<0.001). There was no significant difference between the semiconstrained and unconstrained TER in the post-operative MEPS (p=0.764) and range of motion (p=0.728). The complication rate was much higher in the unconstrained groups than in the semiconstrained group (p=0.014). The mean total revision rate was 29.5%. There was no significant difference in revision rate between the unconstrained and semiconstrained groups (p=0.402). Loosening was found in a total of 12 cases (15.4%). There was also no significant difference in loosening between the semiconstrained and unconstrained groups (p=0.382). CONCLUSION: Favorable results of MEPS and elbow motion were obtained in both the unconstrained and semiconstrained types after an average 13 year follow up after TER. However, the semiconstrained type of TER showed a lower complication rate than the unconstrained type of TER.
Arthritis ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Elbow ; Elbow ; Follow-Up Studies ; Humans ; Korea ; Osteoarthritis ; Prostheses and Implants ; Range of Motion, Articular

Since 1974, we had performed five cases of total elbow replacement; four cases of Coonrad type and one case of Stanmore type. There were done In three cases of comminuted fracture and dislocation of the elbow and two cases of ankylosis of the elbow. We could obtain useful range of motion in three cases and good stability without pain in all the cases. In one case of Coonrad type total elbow, we removed the prosthesis at five years and three months later due to infection of the Joint. In another case of Coonrad type total elbow, there was transitory tourniquet palsy of the arm.
Ankylosis ; Arm ; Arthroplasty, Replacement, Elbow ; Dislocations ; Elbow ; Fractures, Comminuted ; Joints ; Paralysis ; Prostheses and Implants ; Range of Motion, Articular ; Tourniquets

Total elbow arthroplasty was initially used to manage the rheumatoid arthritis of elbow. With the developement of technology in recent decades, the indication of total elbow arthroplasty include the trauma associated unstable joint, traumatic arthritis and distal humerus fractures in elderly. But the high risk of complications, which includes infection, ulnar nerve deficit and tricep insufficiency, is still an unsolved issue. The most widely used approach nowadays is the Bryan-Morrey approach, while some authors also report triceps on approach recently. This article is an overview in approaches and biomechanical researches of total elbow arthroplasy by reviewing the domestic and overseas involved literatures.
Arthroplasty, Replacement, Elbow ; adverse effects ; methods ; Humans ; Muscles ; physiopathology ; Recovery of Function ; Ulnar Nerve ; injuries

Arthroplasty, Replacement ; Elbow Joint ; injuries ; surgery ; Fractures, Bone ; therapy ; Humans ; Joint Dislocations ; therapy

PURPOSE: To analyze the clinical results of revision arthroplasty for aseptic loosening after performing semiconstrained total elbow replacement. MATERIALS AND METHODS: We retrospectively analyzed fifteen patients that had undergone aseptic loosening after semiconstrained total elbow replacement who also had revision arthroplasty. There were 4 men and 11 women, with a mean age of 57 years. The average duration of follow-up was 54 months. The primary causes of arthroplasty were posttraumatic arthrosis (five cases), rheumatoid arthritis (four cases), primary osteoarthritis (four cases), ankylosis (one case) and Charcot joint (one case). For eleven (73%) elbows, the cementing technique was considered marginal or inadequate at the time of primary arthroplasty. An impaction bone graft was used in seven patients at revision, a strut allograft was used in four patients and cement alone was used in four patients. RESULTS: The average preoperative Mayo elbow performance score was 56.6 points; the average postoperative score was 84.5 points. At the latest follow-up, according to the Mayo elbow performance index, six patient elbows showed an excellent result, six patient elbows showed a good result, one patient elbow had a fair result and two patient elbows showed a poor result. Aseptic loosening occurred in three of four elbows that had been revised with cement only. CONCLUSION: Revision arthroplasty for aseptic loosening after semiconstrained total elbow replacement was useful for the relief of pain, maintenance of stability and the activities of daily living. A poor cementing technique and an inadequate selection of implant may be associated with loosening as a main risk factor. Revision using an impaction graft or strut allograft can be a reliable technique for treating a failed total elbow arthroplasty with massive bone loss.
Activities of Daily Living ; Ankylosis ; Arthritis, Rheumatoid ; Arthropathy, Neurogenic ; Arthroplasty ; Arthroplasty, Replacement, Elbow ; Elbow ; Female ; Follow-Up Studies ; Humans ; Male ; Osteoarthritis ; Retrospective Studies ; Risk Factors ; Transplantation, Homologous ; Transplants