Ali Erşen1, Mehmet Demirhan2, Ata Can Atalar1, Ahmet Salduz1, Onur Tunalı1. 1. Istanbul University, Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul, Turkey. 2. Koç University, School of Medicine, Department of Orthopedics and Traumatology, Istanbul, Turkey.
Abstract
OBJECTIVE: The aim of this study was to evaluate the long-term radiological and functional results of distraction interposition arthroplasty using an Achilles tendon allograft. METHODS: The study included 5 patients (3 females and 2 males; mean age: 31 years, range: 25 to 41 years) who underwent distraction interposition arthroplasty for stiff elbow and arthrosis due to intrinsic factors between 2001 and 2010. Interposition with fresh-frozen Achilles allograft and collateral ligament reconstruction were performed in all patients. Mean follow-up period was 87.6 (range: 40 to 131) months. Mean distraction time with an external fixator was 7 (range: 6 to 8) weeks. Elbow motion was allowed in the first postoperative day in all patients. Radiological evaluation was performed pre- and postoperatively. Elbow ROM, and the Mayo Elbow Performance Score (MEPS) and DASH scores were recorded for functional evaluation. RESULTS: Mean preoperative flexion-extension range was 24° (range: 0° to 80°) and mean supination-pronation range was 15°. Two patients had elbow ankylosis in 90° and 60° of flexion at the preoperative examination. Mean postoperative flexion-extension range increased significantly to 81° (range: 50° to 110°) (p<0.05). Mean preoperative DASH score improved from 75.3 (range: 53 to 89) to 18.9 (range: 6.7 to 45.8) postoperatively (p<0.05). Mean postoperative MEPS were poor (mean: 25, range: 20 to 35) while postoperative MEPS were good (mean: 71, range: 70 to 75) in 4 patients and fair in 1 (p<0.05). No patient experienced elbow instability at the final follow-up and none required revision. CONCLUSION: Distraction interposition arthroplasty is a salvage procedure which appears to have good long-term functional results, especially in patients in which elbow arthroplasty is not suitable. The use of Achilles allograft for interposition can protect the joint space in the long-term.
OBJECTIVE: The aim of this study was to evaluate the long-term radiological and functional results of distraction interposition arthroplasty using an Achilles tendon allograft. METHODS: The study included 5 patients (3 females and 2 males; mean age: 31 years, range: 25 to 41 years) who underwent distraction interposition arthroplasty for stiff elbow and arthrosis due to intrinsic factors between 2001 and 2010. Interposition with fresh-frozen Achilles allograft and collateral ligament reconstruction were performed in all patients. Mean follow-up period was 87.6 (range: 40 to 131) months. Mean distraction time with an external fixator was 7 (range: 6 to 8) weeks. Elbow motion was allowed in the first postoperative day in all patients. Radiological evaluation was performed pre- and postoperatively. Elbow ROM, and the Mayo Elbow Performance Score (MEPS) and DASH scores were recorded for functional evaluation. RESULTS: Mean preoperative flexion-extension range was 24° (range: 0° to 80°) and mean supination-pronation range was 15°. Two patients had elbow ankylosis in 90° and 60° of flexion at the preoperative examination. Mean postoperative flexion-extension range increased significantly to 81° (range: 50° to 110°) (p<0.05). Mean preoperative DASH score improved from 75.3 (range: 53 to 89) to 18.9 (range: 6.7 to 45.8) postoperatively (p<0.05). Mean postoperative MEPS were poor (mean: 25, range: 20 to 35) while postoperative MEPS were good (mean: 71, range: 70 to 75) in 4 patients and fair in 1 (p<0.05). No patient experienced elbow instability at the final follow-up and none required revision. CONCLUSION: Distraction interposition arthroplasty is a salvage procedure which appears to have good long-term functional results, especially in patients in which elbow arthroplasty is not suitable. The use of Achilles allograft for interposition can protect the joint space in the long-term.
Authors: R J Molenaars; B J A Schoolmeesters; J Viveen; B The; D Eygendaal Journal: Knee Surg Sports Traumatol Arthrosc Date: 2018-10-19 Impact factor: 4.342
Authors: Fabian Lanzerath; Michael Hackl; Christoph-Johannes Pucher; Tim Leschinger; Stephan Uschok; Lars P Müller; Kilian Wegmann Journal: Int Orthop Date: 2022-08-30 Impact factor: 3.479