Total Elbow Replacement in Rheumatoid Arthritis: A Case Report

/in /by

Vol 02 | January 2021 | page: 24-27 | Amit Das, Saroj Kumar Parida

DOI- https://doi.org/10.13107/ojot.2020.v42i01.021

Authors: Amit Das [1], Saroj Kumar Parida [1]

[1] Department of Orthopaedics, SCB Medical College & Hospital, Cuttack, Odisha, India.

Address of Correspondence

Dr. Amit Das,
SCB Medical College & Hospital, Cuttack, Odisha, India.
E-mail: dasamit374@gmail.com

Abstract

Inflammatory arthropathies such as Rheumatoid arthritis represent the classic indication for
Total elbow arthroplasty(TEA). Indications have been expanded to include posttraumatic
osteoarthritis, acute distal humerus fractures, distal humerus nonunions and reconstruction
after tumour resection. Elbow arthroplasty successful in terms of pain relief, motion and
function. For elderly patients with deformity and ankylosis of the elbow due to Rheumatoid
arthritis, Total Elbow Arthroplasty is one of the valuable options. Here, we present a case of a
female patient suffering from the rheumatoid elbow with significant pain, deformity and
instability. The Semi Constrained hinge type elbow prosthesis was used. Clinico-radiological
follow up was done at 1 month, 3 months, 6 months, 8 months. In the present case at follow
up, supination was 70°, pronation 70°, flexion 135°. The mean Mayo elbow performance
score was 95 points. Clinico-radiologically the elbows were stable and no evidence of
loosening was seen. Elbow arthroplasty remains a valuable option for deformed and unstable
elbows especially in selective patients with crippling deformity of the elbow.
Keywords: Rheumatoid Arthritis; Total Elbow Arthroplasty; Semi-constrained prosthesis.

References

1. Studer A, Athwal GS. Rheumatoid arthritis of the elbow. Hand Clin. 2011;27(2):139–50.
v.
2. Dyer GS, Blazar PE. Rheumatoid elbow. Hand Clin. 2011;27(1):43–8.
3. Govind P, Yogesh P. Total elbow replacement: Baksi sloppy Hinge joint. Jivisha 2011.
4. Morrey BF. Complications of elbow replacement surgery. The Elbow and its disorders. 3rd
ed, Philadelphia: WB Saunders Company; 2000. p. 667-72.
5. Quenneville CE, Austman RL, King GJ, Johnson JA, Dunning CE. Role of an anterior
flange on cortical strains through the distal humerus after total elbow arthroplasty with a
latitude implant. J Hand Surg Am 2008; 33(6): 927-31
6. Fevang BT, Lie SA, Havelin LI, Skredderstuen A, Furnes O.Results after 562 total elbow
replacements: a report from the Norwegian Arthroplasty Register. J Shoulder Elbow Surg
2009;18(3): 449-56
7. Bryan RS, Morrey BF. Extensive posterior exposure of the elbow. A triceps-sparing
approach. Clin Orthop 1982; (166): 188-92.
8. Prokopis PM, Weiland AJ. The triceps-preserving approach for semiconstrained total
elbow arthroplasty. J Shoulder Elbow Surg 2008;17(3): 454-8.
9. Alonso-Llames M. Bilaterotricipital approach to the elbow. Its application in the
osteosynthesis of supracondylar fractures of the humerus in children. Acta Orthop Scand.
1972; 43(6): 479-90
10. Figgie MP, Inglis AE, Mow CS, Figgie HE. Total elbow arthroplasty for complete
ankylosis of the elbow. J Bone Joint Surg Am. 1989; 71: 513-520.
11. Peden JP, Morrey BF. Total elbow replacement for the management of the ankylosed or
fused elbow. J Bone Joint Surg Br. 2008; 90: 1198-1204.
12. Mansat P, Morrey BF. Semiconstrained total elbow arthroplasty for ankylosed and stiff
elbows. J Bone Joint Surg Am. 2000; 82: 1260-1268.
13. Voloshin I, Schippert DW, Kakar S, Kaye EK, Morrey BF. Complications of total elbow
replacement: a systematic review. J Shoulder Elbow Surg. 2011; 20: 158-168.
14. Larson AN, Morrey BE. Interposition arthroplasty with an Achilles tendon allograft as a
salvage procedure for the elbow.J Bone Joint Surg Am 2008;90;2714-23.
15. Bernhard J, Robert A, Moorey BF. Management of acute distal humeral fractures in
patients with rheumatoid arthritis: A case Series. J Bone Joint Surg Am 2008:90:2197-205.
16. O’Driscoll SW, King GJ. Treatment of instability after total elbow arthroplasty.
Orthop Clin North Am 2001;32:679-95.
17. Kraay MJ, Figgie MP, Inglis AE, Wolfe SW, Ranawat CS. Primarysemi constrained total
elbow arthroplasty: Survival analysis of 113 consecutive cases. J Bône Joint Surg Br
1994;76:636-40
18. Prasad N, Dent C. Outcome of total elbow replacement for rheumatoid arthritis: single
surgeon’s series with Souter-Strathclyde and Coonrad-Morrey prosthesis. J Shoulder Elb
Surg/Am Shoulder Elbow Surg [et al]. 2010;19(3):376–83
19. Little C P, Graham A J, Carr A J. Total elbow arthroplasty. A systematic review of the
literature in the English language until the end of 2003. J Bone Joint Surg (Br) 2005a; 87:
437-44.

How to Cite this Article: Das A, Parida SK | Total Elbow Replacement in Rheumatoid Arthritis: A Case Report | Odisha Journal of Orthopaedics and Trauma | January 2021; 02: 24-27. https://doi.org/10.13107/ojot.2020.v42i01.021

(Abstract  Text HTML)      (Download PDF)