Short-term clinical results of revision elbow arthroplasty using the Latitude total elbow arthroplasty

Author:

de Vos M. J.1,Wagener M. L.2,Hannink G.3,van der Pluijm M.4,Verdonschot N.5,Eygendaal D.6

Affiliation:

1. Ter Gooi Hospital, Department of Orthopaedics, PO Box 10016, 1201DA Hilversum, The Netherlands.

2. Rijnstate Hospital, PO Box 9555, 6800TA Arnhem, The Netherlands.

3. Radboud University Medical Center, Orthopaedic Research Lab, PO Box 9101, 6500HB Nijmegen, The Netherlands.

4. Sint Maartenskliniek, PO Box 9011, 6500GM Nijmegen, The Netherlands.

5. Radboud University Medical Center, Orthopaedic Research Lab, PO Box 9101, 6500HB Nijmegen and Laboratory for Biomechanical Engineering, University of Twente, PO Box 217, 7500AE Enschede, The Netherlands.

6. Amphia Hospital, Department of Orthopaedics, PO Box 90157, 4800RL Breda, The Netherlands AMC Hospital, Meibergdreef 91105AZ, Amsterdam, The Netherlands.

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.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Orthopedics and Sports Medicine,Surgery

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