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Elbow arthroplasty

Jason D Vourazeris, Thomas W Wright, Aimee M Struk, Joseph J King, Kevin W Farmer
BACKGROUND: Reverse total shoulder arthroplasty (RTSA) is now performed at nearly the same rate as anatomic total shoulder arthroplasty in the United States. Repair of the subscapularis is of vital importance in total shoulder arthroplasty; however, its utilization in RTSA has recently been questioned. METHODS: This is a retrospective comparative study from prospectively collected data comparing the outcomes and complications after primary RTSA with or without subscapularis repair...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Jeremiah T Lowe, Xinning Li, Sydney M Fasulo, Edward J Testa, Andrew Jawa
BACKGROUND: Patient-reported outcome measures (PROMs) are valuable tools for quantifying outcomes of orthopedic surgery. However, when baseline scores are not obtained, there is considerable controversy about whether PROMs can be administered retrospectively for patients to recall their preoperative state. We investigated the accuracy of patient recall after total shoulder arthroplasty (TSA) using the American Shoulder and Elbow Surgeons (ASES) assessment score. METHODS: Recalled ASES scores were collected postoperatively at 6 weeks, 3 months, 6 months, and 12 months from 169 patients who previously completed baseline scores before TSA...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Brian C Werner, Brenda Chang, Joseph T Nguyen, David M Dines, Lawrence V Gulotta
No abstract text is available yet for this article.
October 13, 2016: Clinical Orthopaedics and related Research
J Christoph Katthagen, Dimitri S Tahal, Travis J Menge, Marilee P Horan, Peter J Millett
HYPOTHESIS: The aim of this study was to assess the effect of open resection arthroplasty for osteoarthritis of the sternoclavicular (SC) joint on pain levels, functional outcomes, and return to sport. METHODS: Patients from a single surgeon's practice who underwent open resection arthroplasty (maximum 10-mm resection) for SC osteoarthritis or prearthritic changes between November 2006 and November 2013 were retrospectively reviewed. This was an outcomes study with prospectively collected data...
October 7, 2016: Journal of Shoulder and Elbow Surgery
Raju Vaishya, Vipul Vijay, Ram Sagar Pandit, Amit K Agarwal
INTRODUCTION: Fractures of the distal humerus are a rare entity accounting for approximately 2% of the humeral fractures. Non union of the distal humerus is further rare and poses a major challenge. These fractures usually respond to open reduction and bone grafting but some may fail multiple surgical attempts at union and hence are labelled as "resistant" non union. We report a case of resistant non union of the distal humerus which was managed by total elbow arthroplasty. CASE PRESENTATION: A 49-year-old male presented to the out patient department with history of a compound comminuted fracture of the distal end of the humerus approximately 25 years back...
April 2016: Journal of Orthopaedic Case Reports
Yaiza Lópiz, Ana González, Carlos García-Fernández, Javier García-Coiradas, Fernando Marco
INTRODUCTION: At present, surgical treatment of comminuted radial head fractures without associated instability continues to be controversial. When anatomical reconstruction is not possible, radial head excision is performed. However, the appearance of long-term complications with this technique, along with the development of new radial head implants situates arthroplasty as a promising surgical alternative. The purpose of the present study was to compare the mid-term functional outcomes of both techniques...
September 2016: Injury
E Van Hoecke, A Van De Vijver, F Van Glabbeek, J Gielen
Radial head fractures are common injuries, occurring mostly in active young people 85%. Treatment of the more complex radial head fractures (Mason type III and IV), appear to be challenging and remain a subject of controversy. Replacement of the radial head with a metal prosthesis imitates the stabilizing role of the radial head and has been considered as the treatment of choice. However, long-term results are scarce. We report our mid to long-term (mean 9.4 year) clinical and radiographic results after insertion of a Judet Bipolar Radial Head prosthesis...
August 2016: Acta Orthopaedica Belgica
Geoffrey C S Smith, Grant Bayne, Richard Page, Jeff S Hughes
BACKGROUND: The aim of the present study was to describe the clinical outcomes and activity levels of young patients after distal humeral hemiarthroplasty (DHH). METHODS: Six patients under 55 years (mean 44 years; range 29 years to 52 years) treated with DHH at a mean postoperative time of 81 months (range 24 months to 133 months) were studied retrospectively. Two other patients had been revised for aseptic loosening and were excluded. RESULTS: The mean Mayo Elbow Score (MEPS) (88), Subjective Elbow Value (SEV) (89), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) (12) and American Shoulder and Elbow Surgeons (ASES) elbow pain (6), function (23) and satisfaction scores (9) were satisfactory...
October 2016: Shoulder & Elbow
Francesco Pogliacomi, Paolo Schiavi, Massimo Defilippo, Maurizio Corradi, Enrico Vaienti, Francesco Ceccarelli, Roberto Rotini, Filippo Calderazzi
BACKGROUND: The treatment of complex distal humerus fractures is challenging and is often associated with unsatisfactory results. Anatomic reduction and stable internal fixation is difficult to obtain, especially in elderly osteoporotic patients. For these reasons, total elbow arthroplasty (TEA) has recently evolved as a valid procedure in selected cases following these injuries. The aim of this study was to analyze outcomes of TEA for the treatment of complex distal humerus fractures in 20 low-demanding patients over 65 years of age...
2016: Acta Bio-medica: Atenei Parmensis
K J Burkhart, B Hollinger
BACKGROUND: In the young patient, treatment of post-traumatic elbow arthritis remains difficult. Total elbow arthroplasty must be delayed for as long as possible. Therapy starts with nonoperative treatment. If this fails, operative options can be discussed. TREATMENT AIM: The aim of surgery is to provide a functional range of motion with acceptable pain without obstructing future treatment options. THERAPY: Patients with pain at terminal extension and/or flexion may benefit from arthroscopic or open debridement...
October 2016: Der Orthopäde
Salvatore Bisicchia, Cosimo Tudisco
Fracture-dislocations of the elbow can be difficult to treat, with unsatisfactory results in some cases. In general, it is preferable to preserve the fractured radial head when possible, but some patients present a unique treatment challenge because of extremely comminuted fractures and bone loss. In these cases, the only options available are radial head prosthesis or allograft. The authors present a case of a 45-year-old man with a fracture-dislocation of the left elbow that was treated with an allograft of the radial head and neck because of extreme comminution of the fracture...
September 8, 2016: Orthopedics
K Schmidt-Horlohé, S Buschbeck, D Wincheringer, M Weißenberger, R Hoffmann
Radial head fractures are common injuries in elbow trauma. Non-displaced fractures are best treated conservatively. Simple but displaced fractures require anatomic reduction and fixation, typically using screws. The treatment course for complex fractures with multiple fragments is still being debated, as results are less predictable. Radial head resection is not advised if concomitant injuries of the coronoid process or the collateral ligaments with instability are present. Favorable outcomes following open reduction and fixation using plates were reported recently...
October 2016: Der Orthopäde
Stefania Vanni, Stefano Marenco, Michel Calò, Bruno Battiston
Radial head represents a secondary elbow stabilizer for varus-valgus and postero-lateral stress. In complex fractures, that cannot be synthesized, the presence of associated ligament injuries makes radial head replacement necessary to restore elbow stability. This study evaluates how the elbow responds to a prosthetic removal after a complex injury repair.
2016: Case Reports in Plastic Surgery & Hand Surgery
Chris A Peach, Amir Salama, David Stanley
The use of cortical windows for revision elbow arthroplasty has not previously been widely reported. Their use aids safe revision of a well fixed humeral prosthesis and can be used in the setting of dislocation, periprosthetic fracture or aseptic loosening of the ulnar component. We describe our technique and results of cortical windows in the distal humerus for revision elbow arthroplasty surgery.
April 2016: Shoulder & Elbow
Amit Sharad Chandra Bidwai, Ann Birch, David Temperley, Saurabh Odak, Michael J Walton, John F Haines, Ian Trail
BACKGROUND: We report on the medium- to long-term results of a randomized controlled trial (RCT) aiming to determine whether rotator cuff repair confers any advantage over arthroscopic sub-acromial decompression (ASAD) alone in the management of medium-sized rotator cuff tears. METHODS: Ethical approval was sought to follow-up patients previously enrolled in a completed and previously published RCT comparing the outcome of ASAD with mini-open cuff repair for the treatment of rotator cuff tear...
April 2016: Shoulder & Elbow
Joideep Phadnis, Gregory I Bain
BACKGROUND: Failure of total elbow arthroplasty is more common than after other major joint arthroplasties and is often a result of aseptic loosening, peri-prosthetic infection, fracture and instability. Infection can be a devastating complication, yet there are no established guidelines for the pre-operative diagnosis of total elbow peri-prosthetic infection. This is because pre-operative clinical, radiographic and biochemical tests are often unreliable. METHODS: Using three case examples, a standardized protocol for the clinical and arthroscopic assessment of the painful total elbow arthroplasty is described...
January 2016: Shoulder & Elbow
Robert Z Tashjian, Man Hung, Jay D Keener, Randy Christopher Bowen, Jared McAllister, Wei Chen, Gregory Ebersole, Erin K Granger, Aaron M Chamberlain
BACKGROUND: Minimal clinically important differences (MCIDs) for the American Shoulder and Elbow Surgeons (ASES) score, the Simple Shoulder Test (SST), and a visual analog scale (VAS) measuring pain have not been previously described using an anchor-based method after shoulder arthroplasty. The purpose of this study was to determine the MCIDs for these measures after shoulder arthroplasty for glenohumeral arthritis or advanced rotator cuff disease. METHODS: Primary anatomic total shoulder arthroplasty (TSA), primary reverse TSA, or hemiarthroplasty was performed in 326 patients by 1 of 5 shoulder and elbow surgeons...
August 18, 2016: Journal of Shoulder and Elbow Surgery
Prospero Bigazzi, Marco Biondi, Massimo Ceruso
Radiocapitellar prosthetic arthroplasty is a fascinating new option in the treatment of complex lesions of the elbow. The device has been developed in order to treat primitive and post-traumatic radiocapitellar degenerative arthritis, while preserving the ulnohumeral joint of the elbow. Compared to a radial head resection, it avoids valgus and axial instability of the elbow and forearm preventing ulnohumeral degeneration. Seven patients have been reviewed with a mean of follow-up of 40 months. Two of them presented with an acute trauma and five of them with a post-traumatic degenerative arthritis involving the radial compartment of the elbow...
August 20, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Helen O'Leary, Keith M Smart, Niamh A Moloney, Catherine M Doody
BACKGROUND: Research suggests that peripheral and central nervous system sensitization can contribute to the overall pain experience in peripheral musculoskeletal (MSK) conditions. It is unclear, however, whether sensitization of the nervous system results in poorer outcomes following the treatment. This systematic review investigated whether nervous system sensitization in peripheral MSK conditions predicts poorer clinical outcomes in response to a surgical or conservative intervention...
August 19, 2016: Pain Practice: the Official Journal of World Institute of Pain
John W Karl, Lauren H Redler, Peter Tang
BACKGROUND: Long-term outcomes of radial head resection for radial head fracture have shown mixed outcomes, depending on the integrity of the soft-tissue stabilizers of the elbow, forearm, and wrist. METHODS: We report a case of a symptomatic delayed proximal migration of the radius after radial head excision for radial neck nonunion which was managed with a staged radial head replacement. Informed consent was obtained from the individual in this case report. RESULTS: At 7 months after radial head replacement, the patient had 90 degrees of forearm supination and 85 degrees of pronation...
2016: Iowa Orthopaedic Journal
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