Total elbow replacement Flashcards
Are current elbow prostheses commercially available for total elbow replacement linked or unlinked?
Unlinked. They are unlinked semiconstrained two-component prostheses.
What materials is the Iowa state total elbow replacement made of?
Cobalt chrome humeral stem component, UHMW polyethylene radioulnar component.
The humeral stem has a porous surface to allow oseointegration. The radioulnar component is cemented.
What materials is the TATE total elbow replacement made of?
Cobalt chrome humeral component, UHMW polyethylene radioulnar component.
Both the humeral and radioulnar components are porous for bony ingrowth.
What are the components of the BANC total elbow replacement system?
What were the changes made to the second generation BANC total elbow replacement system?
Larger transcondylar and medial epicondylar screw to prevent failure, and electron beam melting of the titanium components to improve osseointegration.
What is a relative contraindication to total elbow replacement?
Elbow luxation
What patients might be considered for total elbow replacement?
Older patients with a clearly decreased quality of life due to severe intractable osteoarthritis of the elbow.
The BANC is limited to dogs with severe lameness limited to the medial compartment of the elbow.
What imaging should be performed prior to total elbow replacement?
Radiography for all systems. Arthroscopy should be performed prior to placement of a BANC to assess the extent of articular damage.
What is the surgical approach to the elbow joint for the described total elbow replacement systems?
1) Iowa state: lateral collateral ligament desmotomy. Elbow joint fully luxated.
2) TATE: Osteotomy of the medial humeral epicondyle. Does not require luxation.
3) BANC: Osteotomy of the medial humeral epicondyle. Requires subluxation.
What system is shown in the following radiographs?
Iowa state
What system is shown in the following radiographs?
Tate
What are the primary complications associated with the Iowa State total elbow replacement system?
Elbow joint luxations and fractures of the ulna.
What are the primary complications associated with the TATE total elbow replacement system?
Limited data.
High rate of major (45%) and catastrophic (15%) complications. Infections (30%) occurred frequently.
Elbow luxation has not been reported with this system.
What are the primary complications associated with the BANC total elbow replacement system?
Only three cases reported. No catastrophic failures or chronic complications reported.
In instances of total elbow replacement failure, what revision strategies are available?
Amputation and arthrodesis.
