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1.
Bone Joint J ; 98-B(8): 1086-92, 2016 Aug.
Article in English | MEDLINE | ID: mdl-27482022

ABSTRACT

AIMS: Revision total elbow arthroplasty (TEA) is often challenging. The aim of this study was to report on the clinical and radiological results of revision arthroplasty of the elbow with the Latitude TEA. PATIENTS AND METHODS: Between 2006 and 2010 we used the Latitude TEA for revision in 18 consecutive elbows (17 patients); mean age 53 years (28 to 80); 14 women. A Kudo TEA was revised in 15 elbows and a Souter-Strathclyde TEA in three. Stability, range of movement (ROM), visual analogue score (VAS) for pain and functional scores, Elbow Functional Assessment Scale (EFAS), the Functional Rating Index of Broberg and Morrey (FRIBM) and the Modified Andrews' Elbow Scoring System (MAESS) were assessed pre-operatively and at each post-operative follow-up visit (six, 12 months and biennially thereafter). Radiographs were analysed for loosening, fractures and dislocation. The mean follow-up was 59 months (26 to 89). RESULTS: The ROM of the elbow did not improve significantly. The mean EFAS and MAESS scores improved significantly six months post-operatively (18.6 points, standard deviation (sd) 7.7; p = 0.03 and 28.8 points, sd 8.6; p = 0.006, respectively) and continued to improve slightly or reached a plateau. The mean pain scores at rest (Z = -3.2, p = 0.001) and during activity (Z = -3.2, p = 0.001), and stability (Z = -3.0, p = 0.003) improved significantly six months post-operatively. Thereafter scores continued to improve slightly or a plateau was reached. There were no signs of loosening. CONCLUSION: Revision surgery using the Latitude TEA results in improvement of functionality, reduced pain and better stability of the elbow. Improvement of ROM of the elbow should not be expected. Cite this article: Bone Joint J 2016;98-B:1086-92.


Subject(s)
Arthroplasty, Replacement, Elbow/methods , Adult , Aged , Aged, 80 and over , Arthroplasty, Replacement, Elbow/instrumentation , Elbow Prosthesis , Female , Follow-Up Studies , Humans , Humeral Fractures/diagnostic imaging , Humeral Fractures/physiopathology , Humeral Fractures/surgery , Joint Dislocations/diagnostic imaging , Joint Dislocations/surgery , Joint Instability/surgery , Male , Middle Aged , Pain, Postoperative/prevention & control , Postoperative Complications/diagnostic imaging , Postoperative Complications/surgery , Prosthesis Failure/adverse effects , Prosthesis-Related Infections/diagnostic imaging , Prosthesis-Related Infections/surgery , Range of Motion, Articular/physiology , Reoperation , Therapeutic Irrigation/methods , Treatment Outcome , Young Adult
2.
Bone Joint J ; 97-B(5): 681-8, 2015 May.
Article in English | MEDLINE | ID: mdl-25922464

ABSTRACT

Unlinked, linked and convertible total elbow arthroplasties (TEAs) are currently available. This study is the first to report the clinical results of the convertible Latitude TEA. This was a retrospective study of a consecutive cohort of 63 patients (69 primary TEAs) with a mean age of 60 years (23 to 87). Between 2006 and 2008 a total of 19 men and 50 women underwent surgery. The mean follow-up was 43 months (8 to 84). The range of movement, function and pain all improved six months post-operatively and either continued to improve slightly or reached a plateau thereafter. The complication rate is similar to that reported for other TEA systems. No loosening was seen. Remarkable is the disengagement of the radial head component in 13 TEAs (31%) with a radial head component implanted. Implantation of both the linked and the unlinked versions of the Latitude TEA results in improvement of function and decreased pain, and shows high patient satisfaction at mid-term follow-up.


Subject(s)
Arthroplasty, Replacement, Elbow/methods , Joint Prosthesis , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prosthesis Design , Retrospective Studies , Time Factors , Treatment Outcome , Young Adult
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