The Management of the Failed Total Elbow Arthroplasty

Deep periprosthetic infection affects the elbow more commonly than other joints. This is attributed to the thin soft-tissue envelope of the elbow as well as the higher risk of infection in patients with relative immune suppression secondary to inflammatory conditions or failed previous surgical procedures for trauma. Currently, the incidence of infection after elbow arthroplasty is estimated to be between 2 and 4 per cent [,] Antibiotic-loaded polymethylmethacrylate is used routinely for implant fixation in an effort to decrease the rate of infection. Acute infections may be treated with irrigation, debridement, polyethylene exchange and retention of the components. Chronic infections may be treated with two-stage reimplantation or resection depending on the nature of the infection, patient needs and remaining bone and soft-tissues.

Zimmer (Presentation Conrad-Morrey elbow prosthesis, Shoulder Arthroplasty)

AB - System Identification and modeling methods were employed to investigate how subjects use orientation information provided by a vibrotactile balance prosthesis. Previous results showed systematic, frequency-dependent changes in the dynamic responses to postural perturbations due to surface tilts as a function of prosthesis feedback parameters. These results could be modeled by a relatively simple feedback control model with the contribution from the prosthesis feedback being dependent on the relative proportion of sway position and velocity information encoded by the prosthesis. Results presented here identify candidate "cost functions" that predict this dependency on prosthesis feedback information. The most accurate prediction was obtained from a cost function that included a weighted combination of the root-mean-square values of body sway jerk (3rd derivative of angular body sway) and angular body sway.


Chapter 44 The Management of the Failed Total Elbow ..

The young media and game design students will be showcasing work including animation, computer modelling, rubber prosthetics and interactive pieces.

Schneeberger . [] published the results of a study of 41 patients with posttraumatic osteoarthritis using the Coonrad-Morrey prosthesis. The mean age of the patients at the time of surgery was 57 years (range, 32 to 82 years) and the mean follow-up time was five years. Seventy-three per cent of the patients had no or mild pain and the results were considered satisfactory in 83 per cent of the cases. However, there was a 27 per cent complication rate, including five ulnar component fractures and two revisions for polyethylene wear. These authors concluded that elbow arthroplasty should be relatively contraindicated in patients planning to perform substantial physical activities with the involved upper extremity or are not able to comply with the previously mentioned postoperative restrictions.


Muscle Strengths and Musculoskeletal Geometry of the ..

Mid term results of revision of the Soutar-Strathclyde total elbow prosthesis to a Conrad-Morrey prosthesis
Shoulder and Elbow (2013), Volume 5, Issue 4, pages 276-294 Kiran M, Jariwala A, Wigderowitz CA.

limb and design of an elbow prosthesis

System Identification and modeling methods were employed to investigate how subjects use orientation information provided by a vibrotactile balance prosthesis. Previous results showed systematic, frequency-dependent changes in the dynamic responses to postural perturbations due to surface tilts as a function of prosthesis feedback parameters. These results could be modeled by a relatively simple feedback control model with the contribution from the prosthesis feedback being dependent on the relative proportion of sway position and velocity information encoded by the prosthesis. Results presented here identify candidate "cost functions" that predict this dependency on prosthesis feedback information. The most accurate prediction was obtained from a cost function that included a weighted combination of the root-mean-square values of body sway jerk (3rd derivative of angular body sway) and angular body sway.

Patent US5314485 - Total prosthesis of the wrist - …

Given the malposition and poor quality bone, we elected to proceed with an APC. The residual humeral bone was osteotomized to remove the malunion and cortical shell. Intraoperative tissue samples were sent to pathology and no evidence of acute infection was identified. This left a stable straight cylinder of bone about 1cm to 2cm distal to the shoulder prosthesis. The allograft for the distal humerus was fashioned from an intact tibia diaphysis. All fibrous tissue was removed from the allograft followed by preparation of the canal. A high-speed burr was used to prepare the proximal extent of the allograft to barrel-stave the allograft over the humerus itself. The distal tibial allograft segment was then osteotomized to leave the appropriate length of the humerus distally. A small size humeral component was used to match the ulnar component. The tibia allograft was prepared using the appropriate broaches. Rotation of the tibia allograft was confirmed and the trial component was inserted, followed by reduction of the elbow prosthesis. Near full extension was achieved and flexion beyond 130°. After cleaning the canal, the allograft was retrograde filled with commercially available cement containing gentamicin. The allograft was barrel-staved onto his humerus first. The cement was then placed into the allograft followed by positioning of the implant into the allograft. A small size distal humerus component was then cemented into place. Care was taken to ensure no extravasation of cement at the host-graft and around his radial nerve. The nerve rested free on the proximal aspect of the allograft at the end of the procedure. His ulnar nerve was transposed anteriorly and ensured to be free from tension with a range of motion of his elbow. The deep medial and lateral fascia was closed with a #1 Vicryl suture; a Hemovac drain was placed deep and superficial to his triceps fascia; the subcutaneous tissue was closed with 2-0 Vicryl suture and his skin closed with a 4-0 Monocryl suture.