Elisabeth J Geurts1, Jetske Viveen2, Roger P van Riet3, Izaäk F Kodde2, Denise Eygendaal4. 1. Department of Orthopedics, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: elze.geurts@hotmail.com. 2. Department of Orthopedics, Academic Medical Center, Amsterdam, The Netherlands. 3. Department of Orthopedic Surgery, AZ Monica, Antwerp, Belgium. 4. Department of Orthopedics, Academic Medical Center, Amsterdam, The Netherlands; Upper Limb Unit, Department of Orthopedic Surgery, Amphia, Breda, The Netherlands.
Abstract
BACKGROUND: Although revision arthroplasty surgery is a frequently used treatment for failed total elbow arthroplasty (TEA), published results are conflicting. The aim of this systematic review was to provide an overview of the outcomes of revision TEA surgery. METHODS: A systematic literature search was performed in major databases to find articles relating to outcomes after revision of TEA. Two reviewers independently screened the articles for inclusion, and a third reviewer screened them before final inclusion. RESULTS: Twenty-one articles containing 532 cases were included. The mean age at revision was 61 years. The mean interval between primary and revision arthroplasty was 77 months, and the average follow-up period was 65 months. Different types of prostheses were included, with 69% of the revision prostheses having linked designs and 31% having unlinked designs. The visual analog scale score, Mayo Elbow Performance Score, Oxford Elbow Score, and range of motion improved significantly after revision surgery. Complications were reported in 232 of 532 cases (44%), leading to reoperations in 22%. After revision with linked prostheses, the Mayo Elbow Performance Score, range of flexion-extension, and pronation improved significantly more than with unlinked designs. CONCLUSION: Improved functional outcomes can be expected after revision TEA, but the complication rate remains high. Revision TEA should still be considered a salvage procedure for failed TEA. Linked designs for revision TEA result in better outcomes than unlinked designs in the midterm follow-up.
BACKGROUND: Although revision arthroplasty surgery is a frequently used treatment for failed total elbow arthroplasty (TEA), published results are conflicting. The aim of this systematic review was to provide an overview of the outcomes of revision TEA surgery. METHODS: A systematic literature search was performed in major databases to find articles relating to outcomes after revision of TEA. Two reviewers independently screened the articles for inclusion, and a third reviewer screened them before final inclusion. RESULTS: Twenty-one articles containing 532 cases were included. The mean age at revision was 61 years. The mean interval between primary and revision arthroplasty was 77 months, and the average follow-up period was 65 months. Different types of prostheses were included, with 69% of the revision prostheses having linked designs and 31% having unlinked designs. The visual analog scale score, Mayo Elbow Performance Score, Oxford Elbow Score, and range of motion improved significantly after revision surgery. Complications were reported in 232 of 532 cases (44%), leading to reoperations in 22%. After revision with linked prostheses, the Mayo Elbow Performance Score, range of flexion-extension, and pronation improved significantly more than with unlinked designs. CONCLUSION: Improved functional outcomes can be expected after revision TEA, but the complication rate remains high. Revision TEA should still be considered a salvage procedure for failed TEA. Linked designs for revision TEA result in better outcomes than unlinked designs in the midterm follow-up.
Authors: Setor K Kunutsor; Andrew D Beswick; Michael R Whitehouse; Ashley W Blom Journal: BMC Musculoskelet Disord Date: 2019-10-22 Impact factor: 2.362
Authors: Jetske Viveen; Michel P J van den Bekerom; Job N Doornberg; Alesha Hatton; Richard Page; Koen L M Koenraadt; Christopher Wilson; Gregory I Bain; Ruurd L Jaarsma; Denise Eygendaal Journal: Acta Orthop Date: 2019-08-27 Impact factor: 3.717