In 1972, the senior author designed a condylar-sparing constrained hinge elbow prosthesis with a high-density polyethylene bushing. The condylar-sparing design allows both intercondylar and intramedullary fixation of the humeral component with methylmethacrylate cement. Reattachment of the muscles and collateral ligaments to the preserved condyles provides further stability. The clinical experience spans more than 16 years in 42 elbows with a relatively low loosening rate of 7%. The implant was removed and not replaced in three elbows: one for late infection, one for posttraumatic comminuted fracture of the distal humerus, and one for loosening of a humeral component. A series of 27 patients (31 elbows) with 24-204 months of follow-up study (average, 77 months) had excellent pain relief and an average range of motion of 129 degrees flexion, -44 degrees extension, 69 degrees pronation, and 61 degrees supination.
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http://dx.doi.org/10.1016/s0883-5403(06)80166-x | DOI Listing |
JBJS Rev
January 2025
Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, Florida.
Background: Reverse shoulder arthroplasty (RSA) is increasingly used in the treatment of proximal humerus fractures (PHFs) with reliable clinical improvement. Lateralized RSA implants have conferred superior outcomes compared with the original Grammont design in patients with nontraumatic indications. However, in the setting of a PHF, lateralized components can place increased tension across the tuberosity fracture site and potentially compromise tuberosity healing and outcomes.
View Article and Find Full Text PDFJSES Int
November 2024
Division of Hand and Upper-Extremity Surgery, Department of Orthopaedic Surgery, Geisinger Commonwealth School of Medicine, Geisinger MSKI, Danville, PA, USA.
Background: Revision total elbow arthroplasty (rTEA) remains a technically challenging procedure with potential for substantial morbidity. Cases involving excessively long cement mantles, removal of well-fixed implants or infected revisions requiring complete cement removal introduce additional technical challenges. Our purpose was to describe the outcomes, results, and complications associated with the use of cortical windows in rTEA.
View Article and Find Full Text PDFJSES Int
November 2024
Department of Orthopaedic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Background: The incidence of primary reverse total shoulder arthroplasty (rTSA) and the prevalence of obesity have increased in the United States. Despite this, the literature assessing the effect of morbid obesity (body mass index≥40 kg/m) on perioperative surgical outcomes remains inconsistent.
Methods: A retrospective review of consecutive elective primary rTSA cases from January 2016 through September 2023 at a single tertiary referral center was performed.
J Shoulder Elbow Surg
January 2025
Department of Orthopedic Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, SUNY, Buffalo, NY, USA.
Background: The purpose of this study was to assess the incidence of glenoid and humeral component malposition in failed primary shoulder arthroplasty requiring revision. We hypothesized that glenoid and humeral component malposition would be a prevalent feature in cases requiring revision arthroplasty for primary anatomic TSA, primary RSA, and primary hemiarthroplasty procedures.
Methods: A retrospective cross-sectional study was performed focusing on identifying the incidence of malpositioned components in shoulder arthroplasty in quantitative and qualitative reviews.
J Shoulder Elbow Surg
January 2025
Investigation Performed at the University of Washington, Department of Orthopaedic Surgery and Sports Medicine, Seattle, WA, USA. Electronic address:
Background: While stress shielding and adaptive bone changes around the humeral component are often observed after shoulder arthroplasty, the potential causative factors and clinical significance of these findings at mid-term follow-up have not been well elucidated. The purpose of this study was to investigate the frequency, patterns and clinical significance of radiographic findings around the humeral component of total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) at minimum 4-year follow-up.
Methods: The 6-week and minimum 4-year radiographs of patients who underwent HA and TSA were evaluated for filling ratios, changes in the humeral bone surrounding the component, and component shift or subsidence.
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