The Elbow: Endoprosthetic Replacement and Non-Endoprosthetic Procedures

212 Pages·1996·6.81 MB·English

by  F. Kerschbaumer (auth.), Prof. Dr.med. W. Rüther (eds.)

The Elbow
Springer
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W. Ruther
(Ed.)
The Elbow
Endoprosthetic Replacement
and Non -Endoprosthetic Procedures
With 131 Figures and 19 Tables
Springer
Prof. Dr.med. W. Ruther
Orthopadische Klinik
Heinrich-Heine-U niversitat
Moorenstr. 5
40225 Dusseldorf
Germany
ISBN-13: 978-3-642-79741-5 e-ISBN-13: 978-3-642-79739-2
DOl: 10.1007/978-3-642-79739-2
Library of Congress Cataloging-in-Publication Data. The elbow:endoprosthetic replacement and
non-endoprosthetic procedures/W. Ruther (ed.). p. cm. Includes bibliographical references.
ISBN-13: 978-3-642-79741-5 1. Elbow-Surgery. 2. Total elbow replacement.
I. Ruther, Wolfgang. [DNLM: 1. Elbow-surgery. 2. Elbow Joint-surgery. 3. Prosthesis.
4. Arthroplasty. WE 820 E3837 1995] RD558.E437 1995 617.5'74-dc20 DNLMIDLC for
Library of Congress 95-31211
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Preface
Concepts in total elbow arthroplasty have changed within the past few
years. Various elbow implants are now available which differ mainly
regarding constraint, transmission of load between the implant and
the bone, fixation of components, and required surgical techniques.
In general, according to current clinical experience endoprosthetic
replacement can be offered to patients with painful arthritic or
posttraumatic elbow. However, the question arises as to whether the
classical method of resection arthroplasty still has a role in modern
surgery, particular for arthritis. This is of special interest because re
section arthroplasties have proved to be most useful in the elbow. New
surgical techniques such as distraction arthroplasty indicate that there
is a need for nonendoprosthetic procedures in advanced destruction of
the elbow.
In March 1994 renowned specialists and designers of approved
endoprostheses were invited to a 3-day symposium in Dusseldorf,
Germany, to present their personal experience and to update the infor
mation in the field of elbow arthroplasty. The contributions addressed
issues regarding implant arthroplasties and different types of non
endoprosthetic procedures. The surgical demonstrations in cadaver
specimens emphasized the significance of surgical details and the ne
cessity of skillful surgical technique. The oral presentations, which are
contained in this book, encouraged discussions and illustrated the
convergence and divergence in various procedures. Nearly 150 partici
pants from all over Europe attended this meeting.
We thank Mrs. J. Hemmers for her excellent secretarial assistance.
We acknowledge Mrs. H. Kraffczyk, Dr. P. Dann, Dr. B. Fink, Dr. M.
Possel, Dr. T. Schneider, Dr. M. Strauss, Dr. L. Wiesner, and Dr. S.
Zeisberger for their efforts in the preparation of this meeting, and the
generous cooperation of many manufacturers and companies that
provided financial support. Grateful acknowledgment, moreover, is
given to Prof. Dr. K.-P. Schulitz for his support and the opportunity to
organize this meeting with in the curriculum "Fruhjahrssymposion der
Orthopadischen Klinik, Dusseldorf".
Dusseldorf 1995 W. Ruther
Contents
General Considerations
Surgical Treatment of the Rheumatoid Elbow
F. Kerschbaumer.. . . . . . . . . . . .. . .. . . . . . . . . . . . . . . . . .. . . .. . 3
The Post-Traumatic Elbow - General Considerations
M. Hansis and, S. Arens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Anatomy, Biomechanics, and Kinematics
of Total Elbow Replacement
M.P . Figgie. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Non-Endoprosthetic Procedures
Arthroscopy of the Elbow
C. Jantea, W. Ruther, and A. Baltzer . . . . . . . . . . . . . . . . . . . . . . . 37
Late Synovectomy of the Elbow Joint
A. Wanivenhaus and W. Bretschneider.. . . . . . . . . . . . . . . . . . . . 48
Resection Interposition Arthroplasty of the Elbow
in Rheumatoid Arthritis
W. Ruther and K. TiHmann. . . . . . . .. . . .. . .. . . . .. .. . ... . . .. 57
Distraction Arthroplasty of the Elbow
S.W. O'DriscoH and B.F. Morrey. . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Alloarthroplasty of the Elbow
GSB III Elbow
N. Gschwend, H. Scheier, A. Bahler, and B. Simmen . . . . . . . . . . 83
VIII Contents
Elbow Replacement Arthroplasty for Flail
and Ankylosed Elbows
A.E. Inglis .......~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Coonrad-Morrey Semiconstrained Total Elbow Arthroplasty
S.W. Q'Driscoll and B.F. Morrey. . . . . .. . .. . . . . .. . .. . . . . . . .. III
The Norway Elbow System
F. Risung. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 121
Cementless or Hybrid Total Elbow Arthroplasty - A Study
of Interim Clinical Results and Specific Complications
H. Kudo............................................... 128
Early Results with the Capitellocondylar Total Elbow
Prosthesis in Rheumatoid Arthritis
P. Ljung and U. Rydholm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 135
Complications After Total Elbow Arthroplasty
Unusual Solutions to Different Situations
A. Sosna, 1. Landor, and M. Richtr. . . . . . . . . . . . . . . . . . . . . . . .. 140
The Guildford Elbow
P.J. Stiles.. ..... ........... ... .......... .. .. ..... ...... 145
Complications and Salvage Procedures
Reconstructions with the GSB III Prosthesis
B.R. Simmen and N. Gschwend . .. .... .... .. ... ........... 153
Revision Total Elbow Replacement
M.P. Figgie. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 165
Management of Problems Associated with Total Elbow
Arthroplasty - Problems of Revision, Severe Bone Defect,
Ulnar Nerve Neuropathy, and Total Elbow Arthroplasty
for Fractured Elbow
H. Kudo............................................... 185
Complications After Capitellocondylar Elbow Replacement
via the Lateral Approach
P. Ljung and U. Rydholm . . . . . .. . . . . . . . .. . . . . . . . . . . . .. . .. 195
Elbow Reconstruction Using Cadaveric Allograft
and an Elbow Endoprosthesis
D. Stanley . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 200
List of Contributors
Arens, S.
Klinik und Poliklinik fUr Unfallchirurgie, Sigmund-Freud-Str. 25,
53105 Bonn-Venusberg, Germany
Bahler, A.
Schulthess Klinik, Neumunsterallee 3, 8008 Zurich, Switzerland
Baltzer, A.
Orthopedic Clinic, University of Dusseldorf, Moorenstr. 5,
40225 Dusseldorf, Germany
Bretschneider, W.
Department of Orthopedics, University of Vienna,
Wahringer Gurte118-20, 1090 Vienna, Austria
Figgie, M.P.
The Hospital for Special Surgery, Cornell University Medical College,
New York, NY 10021, USA
Gschwend, N.
Schulthess Klinik, Neumunsterallee 3, 8008 Zurich, Switzerland
Hansis, M.
Klinik und Poliklinik fUr Unfallchirurgie, Sigmund-Freud-Str. 25,
53105 Bonn-Venusberg, Germany
Inglis, A.E.
Center for Advanced Orthopaedic Surgery, 1725 York Avenue,
New York, NY 10128, USA
Jantea, C.
Orthopedic Clinic, University of Dusseldorf, Moorenstr. 5,
40225 Dusseldorf, Germany
Kerschbaumer, F.
Department of Surgery of Rheumatoid Arthritis,
University of Frankfurt, Marienburgstr. 2,
60528 Frankfurt, Germany
X List of Contributors
Kudo, H.
Chief of Orthopaedic Section, Sagamihara National Hospital,
Sakuradi, Sagamihara City, Kanagawa, Japan
Landor, I.
Prednosta Ortopedicka Klinika, Na Bojisti I, 12821 Praha 2,
Czech Republic
Ljung, P.
Department of Orthopedics, University Hospital, 22185 Lund,
Sweden
Morrey, B.F.
Department of Orthopedics, Mayo Clinic, Rochester, MN 55905, USA
O'Driscoll, S.W.
Department of Orthopedics, Mayo Clinic, Rochester, MN 55905, USA
Richtr, M.
Prednosta Ortopedicka Klinika, Na Bojisti I, 12821 Praha 2,
Czech Republic
Risung, F.
Department of Rheuma Surgery, Betanien Hospital,
3722 Skien, Norway
Ruther, W.
Orthopedic Clinic, University of Dusseldorf, Moorenstr. 5,
40225 Dusseldorf, Germany
Rydholm, U.
Department of Orthopedics, University Hospital, 22185 Lund,
Sweden
Scheier, H.
Schulthess Klinik, Neumunsterallee 3, 8008 Zurich, Switzerland
Simmen, B.
Schulthess Klinik, Neumunsterallee 3, 8008 Zurich, Switzerland
Sosna, A.
Prednosta Ortopedicke Klinika 1 LF UK, Na Bojisti I,
12821 Praha 2, Czech Republic
List of Contributors XI
Stanley, D.
Department of Orthopaedics, Northern General Hospital Trust,
Herries Road, Sheffield S5 7A U, England
Stiles, P.J.
Royal Country Hospital, 5, Fairway Merraow, Guildford GUI ZXG
Tillmann, K.
Orthopadische Abteilung in der Rheuma Klinik Bad Bramstedt
GmbH, Postfach 1448,24572 Bad Bramstedt, Germany
Wanivenhaus, A.
Department of Orthopedics, University of Vienna,
Wahringer GtirtelI8-20, 1090 Vienna, Austria