Celli, J Bone Joint Surg Am 2005 - Triceps Insufficiency Following Total Elbow Arthroplasty

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Triceps Insufficiency Following Total Elbow Arthroplasty

Celli, Morrey, et al.·J Bone Joint Surg Am·2005·122 citations·Retrospective cohort

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Background

Over the past decade, the indications for total elbow arthroplasty have increased. One complication that is well recognized but is poorly described in the literature is insufficiency of the extensor mechanism involving complete or partial rupture, or avulsion, of the triceps tendon. We therefore reviewed the records of patients who had undergone surgery for the treatment of triceps insufficiency following total elbow arthroplasty to determine the management options and outcomes of intervention for this problem.

Methods

The records on 887 total elbow arthroplasties performed between 1982 and 2001 were assessed to identify patients who had undergone a subsequent procedure on the triceps.
Patients in whom triceps insufficiency developed after débridement for infection were excluded, leaving 16 elbows in 14 patients.
A Mayo Elbow Performance Score was calculated and elbow extension strength against gravity was measured at the time of final follow-up.

Results

There were 7 male and 7 female patients.
The mean age was 54 years.
The mean duration of follow-up after the triceps reconstruction was 67 months.
3 basic techniques were used to repair or reconstruct the extensor mechanism; these included direct suture in 7 elbows, anconeus rotation in 4, and use of an Achilles tendon allograft in 4.
The capacity to extend against gravity was restored to 15 of the 16 elbows.
According to the Mayo Elbow Performance Score, 11 elbows had an excellent outcome, 3 had a good outcome, and 2 were considered a clinical failure.

Conclusions

In most patients with triceps insufficiency following total elbow arthroplasty, it is possible to reconstruct the triceps mechanism with a procedure appropriately selected on the basis of tissue quality, tendon retraction, and the status of the olecranon.

Level of evidence: Therapeutic Level IV. Copyright remains with the authors and publisher.

Triceps Insufficiency Following Total Elbow Arthroplasty.

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Triceps Insufficiency Following Total Elbow Arthroplasty

Celli, Morrey, et al.·J Bone Joint Surg Am·2005·122 citations·Retrospective cohort

|

Background

Over the past decade, the indications for total elbow arthroplasty have increased. One complication that is well recognized but is poorly described in the literature is insufficiency of the extensor mechanism involving complete or partial rupture, or avulsion, of the triceps tendon. We therefore reviewed the records of patients who had undergone surgery for the treatment of triceps insufficiency following total elbow arthroplasty to determine the management options and outcomes of intervention for this problem.

Methods

The records on 887 total elbow arthroplasties performed between 1982 and 2001 were assessed to identify patients who had undergone a subsequent procedure on the triceps.
Patients in whom triceps insufficiency developed after débridement for infection were excluded, leaving 16 elbows in 14 patients.
A Mayo Elbow Performance Score was calculated and elbow extension strength against gravity was measured at the time of final follow-up.

Results

There were 7 male and 7 female patients.
The mean age was 54 years.
The mean duration of follow-up after the triceps reconstruction was 67 months.
3 basic techniques were used to repair or reconstruct the extensor mechanism; these included direct suture in 7 elbows, anconeus rotation in 4, and use of an Achilles tendon allograft in 4.
The capacity to extend against gravity was restored to 15 of the 16 elbows.
According to the Mayo Elbow Performance Score, 11 elbows had an excellent outcome, 3 had a good outcome, and 2 were considered a clinical failure.

Conclusions

In most patients with triceps insufficiency following total elbow arthroplasty, it is possible to reconstruct the triceps mechanism with a procedure appropriately selected on the basis of tissue quality, tendon retraction, and the status of the olecranon.

Level of evidence: Therapeutic Level IV. Copyright remains with the authors and publisher.

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