RESUMO
Unlinked total elbow arthroplasty (TEA), which has no mechanical connection between the humeral and ulnar components, has theoretical advantages based on its near-normal elbow kinematics and the preservation of bone stock. Unlinked TEA is appropriate only for patients who have limited bone loss or limited deformity and good ligamentous function. This is because postoperative instability has been a major complication of unlinked prostheses. The concept and goal of unlinked TEA is to share the loading stress on the bone implant interface with the surrounding tissues. Although the loosening rate of unlinked prostheses theoretically should be lower than that of linked prostheses (which have a mechanical connection between the humeral and ulnar components), there is no clear evidence that unlinked TEAs are superior to linked TEAs in this respect. However, we believe that primary TEA should be performed using an unlinked TEA, especially for younger patients, because revision surgery for unlinked TEA results in longer prosthesis survival than revision surgery for linked TEA. Improvement of the design of unlinked prostheses and the introduction of less invasive surgical techniques are required to reduce postoperative instability.
Assuntos
Artroplastia de Substituição do Cotovelo/métodos , Articulação do Cotovelo/cirurgia , Prótese de Cotovelo , Instabilidade Articular/cirurgia , Desenho de Prótese/métodos , Reoperação/estatística & dados numéricos , Artroplastia de Substituição do Cotovelo/história , Artroplastia de Substituição do Cotovelo/tendências , Fenômenos Biomecânicos , História do Século XX , História do Século XXI , Humanos , Úmero/cirurgia , Instabilidade Articular/etiologia , Instabilidade Articular/fisiopatologia , Complicações Pós-Operatórias , Desenho de Prótese/história , Desenho de Prótese/tendências , Falha de Prótese , Resultado do Tratamento , Ulna/cirurgiaRESUMO
Understanding of the distal biceps anatomy, mechanics, and biology during the last 75 years has greatly improved the physician's ability to advise and to treat patients with ruptured distal tendons. The goal of this paper is to review the past and current advances on complete distal biceps ruptures as well as controversies and future directions that were discussed and debated during the closed American Shoulder and Elbow Surgeons meeting in 2015.
Assuntos
Artroplastia de Substituição do Cotovelo/história , Artroplastia do Ombro/história , Articulação do Cotovelo/cirurgia , Músculos Isquiossurais/lesões , Músculos Isquiossurais/cirurgia , História do Século XIX , História do Século XX , Humanos , Ortopedia/história , Sociedades Médicas , Traumatismos dos Tendões/cirurgia , Estados UnidosRESUMO
Painful arthritis of the elbow joint has long been a challenging problem. Elbow arthroplasty has emerged as viable treatment method for many patients. Implant design and surgical technique have evolved to provide more predict-able symptom relief without compromising function. Elbow arthroplasty can now be used to treat a wide variety of conditions, including osteoarthritis, rheumatoid arthritis, and fractures. This review article presents historical and contemporary perspectives on elbow arthroplasty. A thorough discussion of implant design, surgical technique, and clinical outcomes is presented.
