Total elbow arthroplasty (TEA) is increasingly used, especially in patients with rheumatoid arthritis (RA) and distal humerus fractures (DHFs). This narrative review of the recent literature published in 2022 reached the following conclusions: 1) Age greater than 80 is not a contraindication for TEA. 2) The estimated 10-year survival reported for linked TEAs is 92%, and unlinked TEAs 84%. 3) For DHFs in the elderly, regarding the flexion/extension arc, TEA gives substantially better results than open reduction and internal fixation (ORIF). The reoperation and elbow stiffness rates are substantially lower in TEA than in ORIF. 4) Comparing distal humeral hemiarthroplasty (DHH) vs. TEA in individuals over 65 years with a non-reconstructable DHF favors DHH regarding the range of motion but with a similarly high rate of adverse events in the two surgical techniques. 5) The rate of eradication of periprosthetic joint infection (PJI) is 69-76% with two-stage, 71% with resection arthroplasty, 67% with one-stage, 58% with DAIR, and 40% with elbow arthrodesis.
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http://dx.doi.org/10.22038/ABJS.2023.71082.3323 | DOI Listing |
J Shoulder Elbow Surg
December 2024
Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. Electronic address:
Objectives: Rheumatoid arthritis often leads to debilitating damage in the elbow joint, which may require total elbow arthroplasty (TEA). The Kudo TEA is one of the unlinked type prostheses with reportedly favorable outcomes. However, there is limited information available regarding its long-term performance.
View Article and Find Full Text PDFShoulder Elbow
December 2024
Specialty Orthopaedic Upper Limbs Surgery Research Foundation, Bella Vista, NSW, Australia.
Background: This study aimed to determine the revision outcome between a centrally fixed stemless anatomic design and other total anatomic shoulder replacements using data from a large national arthroplasty registry.
Methods: The study period was from December 2011 to December 2022 and included three cohorts; primary Affinis stemless anatomic (AFS), all other primary total stemless anatomic (sTSA) and primary total stemmed anatomic shoulder arthroplasty (aTSA). The endpoint was all-cause revision using cumulative percent revision (CPR).
J Shoulder Elbow Surg
December 2024
Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA. Electronic address:
Introduction: Higher perioperative opioid use has been associated with an increase in periprosthetic joint infection, thromboembolic complications, respiratory events, gastrointestinal complications, cost, and length of stay following hip and knee arthroplasty. Limited data exists regarding the relationship between the postoperative opioid dose and complication rates following primary total shoulder arthroplasty (TSA). The purpose of this study is to investigate the relationship between perioperative opioid consumption and postoperative complications following TSA.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
December 2024
Shoulder and Elbow Division, Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA.
Background: Patients undergoing reverse shoulder arthroplasty (RSA) for rotator cuff arthropathy may present with an external rotation (ER) lag due to posterior rotator cuff insufficiency. As a result, the addition of a latissimus dorsi (LD) tendon transfer in combination with RSA has become increasingly utilized. Initial descriptions of LD tendon transfer involved rerouting of the LD tendon posterior to the long head of the triceps tendon.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
December 2024
Barnet and Chase Farm Hospitals, Royal Free London NHS Foundation Trust, London, UK.
Background: The optimal treatment of 3- and 4-part proximal humeral fractures in older adults remains controversial. This aim of this study was compare patient reported outcomes following reverse shoulder arthroplasty (RSA) or non-operative management in patients over 60 years old.
Methods: A retrospective review was undertaken of patients following 3- or 4-part proximal humeral fractures treated with RSA or non-operative treatment with minimum 2-year follow-up.
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