Effectiveness of total elbow arthroplasty with preservation of triceps brachii insertion approach_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Qing ,  XIANG Ming , CHEN Hang , HU Xiaochuan , LI Yiping , ZHENG Jinwen , DENG Mingyue

Department of Upper Limb, Sichuan Provincial Orthopedics Hospital, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

XIANG Ming, Email: josceph_xm@sina.com

Keywords：

Total elbow arthroplasty; distal humerus fracture; osteoarthritis; rheumatoid arthritis

DOI：

10.7507/1002-1892.201903029

Video：

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Objective To investigate the effectiveness of total elbow arthroplasty (TEA) with preservation of triceps brachii insertion approach.Methods Between January 2012 and September 2017, 17 patients with elbow disease were treated with TEA with preservation of triceps brachii insertion approach. There were 3 males and 14 females, with an average age of 65.2 years (range, 48-85 years). The injuries located on left elbow in 5 cases and on right elbow in 12 cases. There were 11 cases of distal humerus fracture (AO type C1 in 2 cases and type C3 in 9 cases); the interval between fracture and operation was 3-10 days (mean, 4.1 days). There were 3 cases of osteoarthritis and 3 cases of rheumatoid arthritis, with the disease duration of 2-26 years (mean, 8.7 years). The postoperative elbow function and pain was assessed by Mayo elbow performance score (MEPS) and visual analogue scale (VAS) score, respectively. The prosthesis position, heterotopic ossification, and periprosthetic fracture were observed by X-ray films.Results All incisions healed by first intention. Sixteen patients were followed up 18-69 months (mean, 40.6 months). Intraoperative ulnar nerve injury occurred in 2 cases, and healed after symptomatic treatment. At last follow-up, the MEPS score was 55-100 (mean, 90.3). The results were excellent in 11 cases, good in 2 cases, fair in 2 cases, and poor in 1 case, with an excellent and good rate of 81.3%. The VAS score was 0-2 (mean, 0.4). X-ray reexamination showed that no polyethylene wear, prosthesis loosening and fracture, abnormal prosthesis position, periprosthetic fracture occurred during the follow-up period, and the prosthesis survival rate was 100%. Heterotopic ossification occurred in 2 and 3 months after operation in 2 cases, respectively.Conclusion The triceps on approach for TEA are satisfactory for distal humerus fracture, osteoarthritis, and rheumatoid arthritis.

Citation： ZHANG Qing, XIANG Ming, CHEN Hang, HU Xiaochuan, LI Yiping, ZHENG Jinwen, DENG Mingyue. Effectiveness of total elbow arthroplasty with preservation of triceps brachii insertion approach. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(7): 845-849. doi: 10.7507/1002-1892.201903029 Copy

1.	Sanchez-Sotelo J, Morrey BF. Linked elbow replacement: a salvage procedure for distal humeral nonunion. Surgical technique. J Bone Joint Surg (Am), 2009, 91(Suppl 2): 200-212.
2.	Sanchez-Sotelo J, Baghdadi YM, Morrey BF. Primary linked semiconstrained total elbow arthroplasty for rheumatoid arthritis: a single-institution experience with 461 elbows over three decades. J Bone Joint Surg (Am), 2016, 98(20): 1741-1748.
3.	Barco R, Streubel PN, Morrey BF, et al. Total elbow arthroplasty for distal humeral fractures: A ten-year-minimum follow-up study. J Bone Joint Surg (Am), 2017, 99(18): 1524-1531.
4.	Morrey BF, Sanchez-Sotelo J. Approaches for elbow arthroplasty: how to handle the triceps. J Shoulder Elbow Surg, 2011, 20(2 Suppl): S90-S96.
5.	Ramsey ML, Adams RA, Morrey BF. Instability of the elbow treated with semiconstrained total elbow arthroplasty. J Bone Joint Surg (Am), 1999, 81(1): 38-47.
6.	Morrey BF, Bryan RS, Dobyns JH, et al. Total elbow arthroplasty. A five-year experience at the Mayo Clinic. J Bone Joint Surg (Am), 1981, 63(7): 1050-1063.
7.	Little CP, Graham AJ, Carr AJ. Total elbow arthroplasty: a systematic review of the literature in the English language until the end of 2003. J Bone Joint Surg (Br), 2005, 87(4): 437-444.
8.	Dachs RP, Fleming MA, Chivers DA, et al. Total elbow arthroplasty: outcomes after triceps-detaching and triceps-sparing approaches. J Shoulder Elbow Surg, 2015, 24(3): 339-347.
9.	Booker SJ, Smith CD. Triceps on approach for total elbow arthroplasty: worth preserving? A review of approaches for total elbow arthroplasty. Shoulder Elbow, 2017, 9(2): 105-111.
10.	King A, Booker SJ, Thomas WJ, et al. Triceps on, alignment off? A comparison of total elbow arthroplasty component positioning with a triceps-on and a triceps-off approach. Ann R Coll Surg Engl, 2018, 100(8): 1-6.
11.	Studer A, Athwal GS, MacDermid JC, et al. The lateral para-olecranon approach for total elbow arthroplasty. J Hand Surg (Am), 2013, 38(11): 2219-2226.
12.	Voloshin I, Schippert DW, Kakar S, et al. Complications of total elbow replacement: a systematic review. J Shoulder Elbow Surg, 2011, 20(1): 158-168.
13.	Throckmorton T, Zarkadas P, Sanchez-Sotelo J, et al. Failure patterns after linked semiconstrained total elbow arthroplasty for posttraumatic arthritis. J Bone Joint Surg (Am), 2010, 92(6): 1432-1441.
14.	Bai XS, Petscavage-Thomas JM, Ha AS. Total elbow arthroplasty: a radiographic outcome study. Skeletal Radiol, 2016, 45(6): 789-794.
15.	何树坤, 黄富国. 创伤后肘关节异位骨化研究进展. 中国修复重建外科杂志, 2015, 29(6): 777-782.

1. Sanchez-Sotelo J, Morrey BF. Linked elbow replacement: a salvage procedure for distal humeral nonunion. Surgical technique. J Bone Joint Surg (Am), 2009, 91(Suppl 2): 200-212.
2. Sanchez-Sotelo J, Baghdadi YM, Morrey BF. Primary linked semiconstrained total elbow arthroplasty for rheumatoid arthritis: a single-institution experience with 461 elbows over three decades. J Bone Joint Surg (Am), 2016, 98(20): 1741-1748.
3. Barco R, Streubel PN, Morrey BF, et al. Total elbow arthroplasty for distal humeral fractures: A ten-year-minimum follow-up study. J Bone Joint Surg (Am), 2017, 99(18): 1524-1531.
4. Morrey BF, Sanchez-Sotelo J. Approaches for elbow arthroplasty: how to handle the triceps. J Shoulder Elbow Surg, 2011, 20(2 Suppl): S90-S96.
5. Ramsey ML, Adams RA, Morrey BF. Instability of the elbow treated with semiconstrained total elbow arthroplasty. J Bone Joint Surg (Am), 1999, 81(1): 38-47.
6. Morrey BF, Bryan RS, Dobyns JH, et al. Total elbow arthroplasty. A five-year experience at the Mayo Clinic. J Bone Joint Surg (Am), 1981, 63(7): 1050-1063.
7. Little CP, Graham AJ, Carr AJ. Total elbow arthroplasty: a systematic review of the literature in the English language until the end of 2003. J Bone Joint Surg (Br), 2005, 87(4): 437-444.
8. Dachs RP, Fleming MA, Chivers DA, et al. Total elbow arthroplasty: outcomes after triceps-detaching and triceps-sparing approaches. J Shoulder Elbow Surg, 2015, 24(3): 339-347.
9. Booker SJ, Smith CD. Triceps on approach for total elbow arthroplasty: worth preserving? A review of approaches for total elbow arthroplasty. Shoulder Elbow, 2017, 9(2): 105-111.
10. King A, Booker SJ, Thomas WJ, et al. Triceps on, alignment off? A comparison of total elbow arthroplasty component positioning with a triceps-on and a triceps-off approach. Ann R Coll Surg Engl, 2018, 100(8): 1-6.
11. Studer A, Athwal GS, MacDermid JC, et al. The lateral para-olecranon approach for total elbow arthroplasty. J Hand Surg (Am), 2013, 38(11): 2219-2226.
12. Voloshin I, Schippert DW, Kakar S, et al. Complications of total elbow replacement: a systematic review. J Shoulder Elbow Surg, 2011, 20(1): 158-168.
13. Throckmorton T, Zarkadas P, Sanchez-Sotelo J, et al. Failure patterns after linked semiconstrained total elbow arthroplasty for posttraumatic arthritis. J Bone Joint Surg (Am), 2010, 92(6): 1432-1441.
14. Bai XS, Petscavage-Thomas JM, Ha AS. Total elbow arthroplasty: a radiographic outcome study. Skeletal Radiol, 2016, 45(6): 789-794.
15. 何树坤, 黄富国. 创伤后肘关节异位骨化研究进展. 中国修复重建外科杂志, 2015, 29(6): 777-782.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of total elbow arthroplasty with preservation of triceps brachii insertion approach

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