Total elbow arthroplasty: Influence of implant positioning on functional outcomes
Autor: | I. Djerbi, Bertrand Coulet, Hubert Lenoir, Cyril Lazerges, Jean-Paul Micallef, Michel Chammas, Thomas Waitzenegger |
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Přispěvatelé: | Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Euromov (EuroMov), Université de Montpellier (UM), Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM) |
Rok vydání: | 2015 |
Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Elbow Elbow Prosthesis [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery Patient Positioning 03 medical and health sciences 0302 clinical medicine Elbow Joint Dash Humans Medicine Orthopedics and Sports Medicine Humerus 030212 general & internal medicine Range of Motion Articular Aged Retrospective Studies Aged 80 and over 030222 orthopedics biology business.industry Arthroplasty Replacement Elbow Ulna Soft tissue Retrospective cohort study Middle Aged musculoskeletal system biology.organism_classification Surgery Total elbow arthroplasty body regions Valgus medicine.anatomical_structure [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system Rotation axis Female Implant Anatomy Joint Diseases business Positioning |
Zdroj: | Orthopaedics and Traumatology-Surgery and Research Orthopaedics and Traumatology-Surgery and Research, Elsevier, 2015, 101 (6), pp.721-727. ⟨10.1016/j.otsr.2015.07.008⟩ |
ISSN: | 1877-0568 |
Popis: | 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. Level of evidence III. |
Databáze: | OpenAIRE |
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