Total Elbow Arthroplasty in the Context of a Nonunion of the Olecranon. Surgical Technique and Report of 3 Cases
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Published:
Jun 15, 2021
Keywords:
Total elbow prosthesis, olecranon nonunion, triceps deficiency, absorber-traction system
Main Article Content
Abstract
The integrity of the extensor apparatus is essential for the correct functioning of an elbow prosthesis. Triceps deficiency has been considered a relative contraindication for arthroplasty, because it produces a flexion contracture and an active extension deficit. These limitations can significantly affect the functional improvement that total elbow arthroplasty produces. Faced with an olecranon nonunion, the placement of a total elbow prosthesis is presented as a complex problem to be solved. The objective of this article is to describe the surgical technique for the placement of a total elbow prosthesis in the context of an olecranon nonunion, and to report three cases.
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How to Cite
Gallucci, G., Rellán, I., Boretto, J., Donndorff, A., Zaidenberg, E., & De Carli, P. (2021). Total Elbow Arthroplasty in the Context of a Nonunion of the Olecranon. Surgical Technique and Report of 3 Cases. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 86(3), 428-436. https://doi.org/10.15417/issn.1852-7434.2021.86.3.1183
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Postgraduate instruction
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22. Mouhsine E, Akiki A, Castagna A, Cikes A, Wettstein M, Borens OR, et al. Transolecranon anterior fracture
dislocation. J Shoulder Elbow Surg 2007;16(3):352-57. https://doi.org/10.1016/j.jse.2006.07.005
defects. Orthopade 2017;46(12):990-1000. https://doi.org/10.1007/s00132-017-3493-4
2. Kwak JM, Koh KH, Jeon IH. Total elbow arthroplasty: clinical outcomes, complications, and revision surgery. Clin Orthop Surg 2019;11(4):369-79. https://doi.org/10.4055/cios.2019.11.4.369
3. Wang JH, Ma HH, Chou TA, Tsai SW, Chen CF, Wu PK, et al. Outcomes following total elbow arthroplasty for
rheumatoid arthritis versus post-traumatic conditions: a systematic review and meta-analysis. Bone Joint J Br
2019;101(12):1489-97. https://doi-org/10.1302/0301-620X.101B12.BJJ-2019-0799.R1
4. Moro JK, King GJ. Total elbow arthroplasty in the treatment of posttraumatic conditions of the elbow. Clin Orthop Relat Res 2000;(370):102-14. https://doi.org/10.1097/00003086-200001000-00010
5. Toulemonde J, Ancelin D, Azoulay V, Bonnevialle N, Rongières M, Mansat P. Complications and revisions after
semi-constrained total elbow arthroplasty: a mono-centre analysis of one hundred cases. Int Orthop 2016;40(1):73-80. https://doi.org/10.1007/s00264-015-3008-z
6. Viveen J, van den Bekerom MPJ, Doornberg JN, Hatton A, Page R, Koenraadt KLM, et al. Use and outcome of
1,220 primary total elbow arthroplasties from the Australian Orthopaedic Association National Joint Arthroplasty
Replacement Registry 2008-2018. Acta Orthop 2019;90(6):511-16. https://doi.org/10.1080/17453674.2019.1657342
7. Gallucci G, Warner Larrondo Calderón, Boretto J, Castellano Lanterno JA, Terán J, De Carli P. Artroplastia total
de codo para el tratamiento de fracturas de húmero distal en pacientes mayores de 65 años. Rev Asoc Argent Ortop Traumatol 2016;81(2):84-92. https://doi.org/10.15417/521
8. Gallucci G, Gonzalez D, Boretto J, Alfie V, Donndorff A, De Carli P. Artroplastía total del codo. Rev Asoc Argent
Ortop Traumatol 2010;75(1):27-33. Disponible en: https://www.aaot.org.ar/revista/2010/n1/art03.pdf
9. Sanchez-Sotelo J, Morrey BF. Surgical techniques for reconstruction of chronic insufficiency of the triceps. Rotation flap using anconeus and tendon achillis allograft. J Bone Joint Surg Br 2002;84(8):1116-20.
https://doi.org/10.1302/0301-620x.84b8.12902
10. Morrey BF, Adams RA. Semiconstrained elbow replacement for distal humeral nonunion. J Bone Joint Surg Br
1995;77:67-72. PMID: 7822400
11. Morrey BF. Semiconstrained total elbow arthroplasty. En: Morrey BF (ed). The elbow. New York: Raven Press;
1994:231-55.
12. Papagelopoulos PJ, Morrey BF. Treatment of nonunion of olecranon fractures. J Bone Joint Surg Br 1994;76(4):627-35. PMID: 8027154
13. Marra G, Morrey BF, Gallay SH, McKee MD, O’Driscoll S. Fracture and nonunion of the olecranon in total elbow arthroplasty. J Shoulder Elbow Surg 2006;15:486-94. https://doi.org/10.1016/j.jse.2005.10.016
14. Morrey BF, Sanchez-Sotelo J. Approaches for elbow arthroplasty: how to handle the triceps. J Shoulder Elbow Surg 2011;20(2):S90-S96. https://doi.org/10.1016/j.jse.2010.12.004
15. Duquin TR, Jacobson JA, Schleck CD, Larson DR, Sanchez-Sotelo J, Morrey BF. Triceps insufficiency after the
treatment of deep infection following total elbow replacement. Bone Joint J Br 2014;96(1):82-7.
https://doi.org/10.1302/0301-620X.96B1.31127
16. Sanchez-Sotelo J, O’Driscoll S, Morrey BF. Periprosthetic humeral fractures after total elbow arthroplasty:
treatment with implant revision and strut allograft augmentation. J Bone Joint Surg Am 2002;84:1642-50.
PMID: 12208923
17. O’Driscoll SW, Morrey BF. Periprosthetic fractures about the elbow. Orthop Clin North Am 1999;30:319-25.
https://doi.org/10.1016/s0030-5898(05)70086-9
18. Foruria AM, Sanchez-Sotelo J, Oh LS, Adams RA, Morrey BF. The surgical treatment of periprosthetic elbow
fractures around the ulnar stem following semiconstrained total elbow arthroplasty. J Bone Joint Surg Am 2011;93(15):1399-1407. https://doi.org/10.2106/JBJS.J.00102
19. Danziger MB, Healy WL. Operative treatment of olecranon nonunion. J Orthop Trauma 1992;6:290-93.
https://doi.org/10.1097/00005131-199209000-00004
20. Rotini R, Antonioli D, Marinelli A, Katusić D. Surgical treatment of proximal ulna nonunion. Chir Organi Mov
2008;91(2):65-70. https://doi.org/10.1007/s12306-007-0011-6
21. Wong JC, Getz CL, Abboud JA. Adult Monteggia and olecranon fracture dislocations of the elbow. Hand Clin
2015;31(4):565-80. https://doi.org/10.1016/j.hcl.2015.06.006
22. Mouhsine E, Akiki A, Castagna A, Cikes A, Wettstein M, Borens OR, et al. Transolecranon anterior fracture
dislocation. J Shoulder Elbow Surg 2007;16(3):352-57. https://doi.org/10.1016/j.jse.2006.07.005