Total elbow arthroplasty: Influence of implant positioning on functional outcomes

被引:14
作者
Lenoir, H. [1 ]
Micallef, P. [2 ]
Djerbi, I. [1 ]
Waitzenegger, T. [1 ]
Lazerges, C. [1 ]
Chammas, M. [1 ]
Coulet, B. [1 ]
机构
[1] CHU Lapeyronie, Hand & Upper Limb Surg Unit, Lapeyronie Teaching Hosp, F-34295 Montpellier 5, France
[2] Univ Montpellier I, EA 2991, STAPS Sch Sports Sci, Res Lab Movement Hlth M2H, Montpellier, France
关键词
Total elbow arthroplasty; Positioning; Rotation axis; Anatomy; RHEUMATOID-ARTHRITIS; PROXIMAL ULNA; DISTAL HUMERUS; FOLLOW-UP; KINEMATICS; REPLACEMENT; PROSTHESIS; ALIGNMENT; COMPLICATIONS; FIXATION;
D O I
10.1016/j.otsr.2015.07.008
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: Restoring the axis of rotation is often considered crucial to achieving good functional outcomes of total elbow arthroplasty. The objective of this work was to evaluate whether variations in implant positioning correlated with clinical outcomes. Hypothesis: Clinical outcomes are dictated by the quality of implant positioning. Material and methods: A retrospective review was conducted of data from 25 patients (26 elbows). Function was assessed using a pain score, the Disabilities of the Arm, Shoulder, and Hand (DASH) Score, and the Mayo Elbow Performance Score (MEPS). The patients also underwent a clinical evaluation for measurements of motion range and flexion/extension strength. Position of the humeral and ulnar implants was assessed by computed tomography with reconstruction using OsiriX software. Indices reflecting anterior offset, lateral offset, valgus, height, and rotation were computed by subtracting the ulnar value of each of these variables from the corresponding humeral value. These indices provided a quantitative assessment of whether position errors for the two components had additive effects or, on the contrary, counterbalanced each other. Elbows with prosthetic loosening or extensive epiphyseal destruction were excluded. Results: Of the 26 elbows, 5 were excluded. In the remaining 21 elbows, the discrepancy between the humeral and ulnar lateral offsets was significantly associated with pain intensity (P <= 0.05) and the MEPS (P <= 0.05). Anterior position of the ulna relative to the humerus was associated with decreased extension strength (P <= 0.05) and worse results for all functional parameters (P <= 0.05). Discussion: In the absence of loosening, positioning errors seem to adversely affect functional outcomes, probably by placing inappropriate stress on the soft tissues. (C) 2015 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:721 / 727
页数:7
相关论文
共 49 条
  • [41] LOOSE-HINGE TOTAL ELBOW ARTHROPLASTY - AN EXPERIMENTAL-STUDY OF THE EFFECTS OF IMPLANT ALIGNMENT ON 3-DIMENSIONAL ELBOW KINEMATICS
    SCHUIND, F
    ODRISCOLL, S
    KORINEK, S
    AN, KN
    MORREY, BF
    [J]. JOURNAL OF ARTHROPLASTY, 1995, 10 (05) : 670 - 678
  • [42] Schuind F, 1994, J Shoulder Elbow Surg, V3, P191, DOI 10.1016/S1058-2746(09)80035-9
  • [43] Failure of the hinge mechanism in total elbow arthroplasty
    Seitz, William H., Jr.
    Bismar, Hisham
    Evans, Peter J.
    [J]. JOURNAL OF SHOULDER AND ELBOW SURGERY, 2010, 19 (03) : 368 - 375
  • [44] Survivorship and radiological analysis of the standard Souter-Strathclyde total elbow arthroplasty
    Trail, IA
    Nuttall, D
    Stanley, JK
    [J]. JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1999, 81B (01): : 80 - 84
  • [45] Comparison of survivorship between standard and long-stem Souter-Strathclyde total elbow arthroplasty
    Trail, IA
    Nuttal, D
    Stanley, JK
    [J]. JOURNAL OF SHOULDER AND ELBOW SURGERY, 2002, 11 (04) : 373 - 376
  • [46] Limited influence of prosthetic position on aseptic loosening of elbow replacements - 125 elbows followed for an average period of 5.6 years
    van der Lugt, JCT
    Geskus, RB
    Rozing, PM
    [J]. ACTA ORTHOPAEDICA, 2005, 76 (05) : 654 - 661
  • [47] Complications of total elbow replacement: A systematic review
    Voloshin, Ilya
    Schippert, David W.
    Kakar, Sanjeev
    Kaye, Elizabeth Krall
    Morrey, Bernard F.
    [J]. JOURNAL OF SHOULDER AND ELBOW SURGERY, 2011, 20 (01) : 158 - 168
  • [48] The proximal ulna: An anatomic study with relevance to olecranon osteotomy and fracture fixation
    Wang, AA
    Mara, M
    Hutchinson, DT
    [J]. JOURNAL OF SHOULDER AND ELBOW SURGERY, 2003, 12 (03) : 293 - 296
  • [49] The anatomy of the proximal ulna
    Windisch, Gunther
    Clement, Hans
    Grechenig, Wolfgang
    Tesch, Norbert Peter
    Pichler, Wolfgang
    [J]. JOURNAL OF SHOULDER AND ELBOW SURGERY, 2007, 16 (05) : 661 - 666