Ch 53 - Total Elbow Replacement Flashcards

1
Q

What are some recent technoloical advances for total elbow replacements in dogs in general?

A
  • Resurfacing, rather than screwed or stemmed components
  • Titanium, rahter than cobalt chrome alloy
  • ELetron beam melthing rather than bead sintering for interface surface texture
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2
Q

What implant in this?
Decribe some of the features of this implant

A

5th generation Iowa State TER
- Cemented system
- Cobalt chrome humeral component
- 120deg arc UHMW polyethylene r/u component
- Porpous coated condylar surface for bone ingrowth

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3
Q

What impant is this?
Describe some of the features of this implant

A

TATE 3rd generation
- Press-fit, cementless, resurfacing design
- Titanium 3D printed humeral component and r/u backing
- Titanium nitride coating of articular surface of humeral component
- Hydroxyapatite coating of metal-bone interfaces
- 175 degree arc UHMT polyethylele r/u component with titanium backing
- Less invasive approach, “cartridge implant”
- Posts for primary fixation and porous surface for long term stability

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4
Q

What implant is this?
Describe some of the features of this implant

A

BANC (Biomechanically Anatomic, Nonconstrained and Compartmental)
- Non-cemented, resurfacig design
- UHMW polyethylene conican disc press fitted over titanium cylinder and screwed into capitulum
- Shape-matched polished titaniumhemicircular component
- Primary fixation with large transcondylar screw and 2 smaller ulnar screws

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5
Q

What modifications have been made to the TATE elbow?

A
  • Hollow primary fixation posts
  • Hydroxyapatite coating
  • Reduced prosthetic constraint in rotation and mediolateral translation
  • Titanium
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6
Q

What modifications have been made to the BANC?

A
  • Increase in transcondylar screw size from 3.8 to 6.4mm
  • Larger medial epicondyle screw from 3.0mm to 4.5mm
  • Electron beam melting for bone ingrowth
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7
Q

What are potential contraindications of a Total Elbow Replacement?

A
  • Bilateral elbow OA (limited revision options)
  • Systemic or local infections
  • Chronic elbow luxation (including congenital luxation)
  • Severe malunion (Iowa state may still be ok)
  • Neuro dysfunction
  • Skeletally immature
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8
Q

What are the main differences in the surgical procendures for the Iowa state, TATE and BANC elbow replacements?

A
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9
Q

What are the main complications seen with the Iowa State system?

A

Elbow joint luxation and fractures of the ulna

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10
Q

What are the main complications seen with the TATE elbow?

A
  • Humeral fractures
  • Implant malpositioning or loosening

Major/catastrophic complications range from 4-65%
Steep learning curve

By 6-12 months, peak vertical ground force reaction better than contralateral limb and by 2yr had reached a normal value

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