scholarly journals Intramedullary fibula strut bone allograft in a periprosthetic humeral shaft fracture with implant loosening after total elbow arthroplasty

2020 ◽  
Vol 23 (3) ◽  
pp. 152-155
Author(s):  
Young-Hoon Jo ◽  
Seung Gun Lee ◽  
Incheol Kook ◽  
Bong Gun Lee
Keyword(s):  
Internal Fixation ◽  
Periprosthetic Fracture ◽  
Fracture Site ◽  
Implant Loosening ◽  
Cerclage Wire ◽  
Replacement Surgery ◽  
Total Elbow Replacement ◽  
Intramedullary Canal ◽  
Elbow Replacement ◽  
Fibula Strut

Periprosthetic fracture after total elbow replacement surgery is a difficult complication to manage, especially when it comes together with implant loosening. If stem revision and internal fixation of the periprosthetic fracture are performed simultaneously, this would be a very challenging procedure. Most of total elbow replacement implants are cemented type. Cement usage at periprosthetic fracture site may interfere healing of fractured site. Authors underwent internal fixation with use of locking plate and cerclage wire for periprosthetic fracture, allogenous fibular strut bone inserted into the humerus intramedullary canal allowing the fractured site to be more stable without cement usage. At 10-month follow-up, the complete union and good clinical outcome was achieved. We present a novel technique for treating periprosthetic fracture with implant loosening after total elbow replacement surgery, using intramedullary allogenous fibula strut bone graft.

A quantitative analysis of two cementing techniques in total elbow replacement: A cadaveric study

2021 ◽  
pp. 175857322098785
Author(s):  
Maartje Michielsen ◽  
Maxime Masson ◽  
Annemieke van Haver ◽  
Matthias Vanhees ◽  
Roger van Riet
Keyword(s):  
Cadaveric Study ◽  
Filling Degree ◽  
Total Elbow Replacement ◽  
Intramedullary Canal ◽  
Computed Tomography Scanning ◽  
3D Printed ◽  
Elbow Replacement ◽  
Degree Of Filling ◽  
Tomography Scanning ◽  
Cementing Techniques

One of the reasons for failure of total elbow replacement is loosening of the ulnar component. Cementing techniques are often outdated. A special small nozzle is needed for the ulnar component, when a cement gun is used. This may not always be available, or surgeons may prefer to use a syringe. We postulated that the use of a cement gun and smaller nozzle would result in improved filling of the ulnar canal. A cadaveric study was performed in which the ulnas of paired specimens were cemented with a cement gun or with a syringe. A 3D printed ulnar component was inserted and computed tomography scanning was performed on all specimens. Filling of the ulnar intramedullary canal was analysed using 3D reconstructions of the specimens. A greater degree of filling was seen by the use of the cement gun in 85.7%. Filling was 52.7% in the syringe group (25.1–78.7%), compared to 63.3% for the cement gun group ( p < 0.05). The use of a small nozzle cement gun provided a significantly higher filling degree of the ulnar canal. We recommend to always use a cement gun with a specific small nozzle to cement the ulnar component in total elbow arthroplasty.

Influence of Polyethylene Thickness on Axis Pin in Linked Elbow Implant

2013 ◽  
Vol 845 ◽  
pp. 194-198
Author(s):  
Milad Heidari ◽  
Muhamad Noor Harun ◽  
Ardiyansyah Syahrom
Keyword(s):  
Elbow Joint ◽  
Maximum Stress ◽  
Outer Diameter ◽  
Implant Loosening ◽  
Joint Failure ◽  
Total Elbow Replacement ◽  
Humeral Component ◽  
Elbow Replacement ◽  
Loss Of Motion ◽  
Polyethylene Thickness

Elbow joint failure results in weakness, instability, pain and loss of motion. Total Elbow replacement is last way to relief pain and instability. One of available complications after total elbow replacement is bushing wear. Excessive bushing wear may cause instability, pain and inflammatory reply to implant loosening. New prosthetic designs is probably responsible for positive changes to decrease complications. The aim of the present study was to analyze effect of ulnar bushing thickness on transmitted stress to axis pin in linked elbow implant. Axis pin, humeral/ulnar components and polyethylene bushings were modeled. All materials were assumed linear, homogenous, elastic and isotropic. A 50 N force was applied in tip of ulnar component. Distal and proximal of humeral component were fixed. Results showed maximum stress at 94 MPa for axis pin contacting ulnar bushing with 10mm outer diameter while values were 111MPa and 138MPa for ulnar bushing with 9mm and 8mm outer diameters respectively. The present study demonstrates that changing bushing thickness affects stress of axis pin.

Parathyroid hormone promotes cartilage healing after free reduction of mandibular condylar fractures by upregulating Sox9

2021 ◽  
pp. 153537022110271
Author(s):  
Yuanyuan Jia ◽  
Liuqin Xie ◽  
Zhenglong Tang ◽  
Dongxiang Wang ◽  
Yun Hu ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Internal Fixation ◽  
Early Stage ◽  
Rabbit Model ◽  
Mandibular Condyle ◽  
Fracture Site ◽  
Control Group ◽  
Condylar Cartilage ◽  
Cartilage Healing ◽  
Experimental Group

After high fractures of the mandibular condyle, the insufficient blood supply to the condyle often leads to poor bone and cartilage repair ability and poor clinical outcome. Parathyroid hormone (PTH) can promote the bone formation and mineralization of mandibular fracture, but its effects on cartilage healing after the free reduction and internal fixation of high fractures of the mandibular condyle are unknown. In this study, a rabbit model of free reduction and internal fixation of high fractures of the mandibular condyle was established, and the effects and mechanisms of PTH on condylar cartilage healing were explored. Forty-eight specific-pathogen-free (SPF) grade rabbits were randomly divided into two groups. In the experimental group, PTH was injected subcutaneously at 20 µg/kg (PTH (1–34)) every other day, and in the control group, PTH was replaced with 1 ml saline. The healing cartilages were assessed at postoperative days 7, 14, 21, and 28. Observation of gross specimens, hematoxylin eosin staining and Safranin O/fast green staining found that every-other-day subcutaneous injection of PTH at 20 µg/kg promoted healing of condylar cartilage and subchondral osteogenesis in the fracture site. Immunohistochemistry and polymerase chain reaction showed that PTH significantly upregulated the chondrogenic genes Sox9 and Col2a1 in the cartilage fracture site within 7–21 postoperative days in the experimental group than those in the control group, while it downregulated the cartilage inflammation gene matrix metalloproteinase-13 and chondrocyte terminal differentiation gene ColX. In summary, exogenous PTH can stimulate the formation of cartilage matrix by triggering Sox9 expression at the early stage of cartilage healing, and it provides a potential therapeutic protocol for high fractures of the mandibular condyle.

Revision in Total Elbow Replacement with Bone Stock Loss: Surgical Technique and Expected Results

2019 ◽  
pp. 189-198
Author(s):  
A. Ritali ◽  
M. Cavallo ◽  
R. Zaccaro ◽  
M. Ricciarelli ◽  
R. Rotini
Keyword(s):  
Surgical Technique ◽  
Bone Stock ◽  
Total Elbow Replacement ◽  
Elbow Replacement

scholarly journals The Provision of Primary and Revision Elbow Replacement Surgery in the NHS

2018 ◽  
Vol 10 (2_suppl) ◽  
pp. S5-S12 ◽  
Author(s):  
Stuart Hay ◽  
Rohit Kulkarni ◽  
Adam Watts ◽  
David Stanley ◽  
Ian Trail ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Surgical Outcomes ◽  
Surgical Procedure ◽  
Best Practice ◽  
Replacement Surgery ◽  
Practice Recommendations ◽  
Procedure Guidelines ◽  
Elbow Replacement ◽  
First Time ◽  
British Orthopaedic Association

BESS Surgical Procedure Guidelines (SPGs). Optimising Surgical Outcomes for Shoulder and Elbow patients. The British Elbow and Shoulder Society (BESS) SPGs are a series of evidence and consensus Best Practice Recommendations developed by BESS surgeons and physiotherapists to help drive quality improvement and achieve the best possible surgical outcomes for UK patients. This SPG on primary and revision elbow replacement surgery is supported and endorsed by both the British Orthopaedic Association (BOA) and the Getting It Right First Time (GIRFT) Programme.

scholarly journals Advantages and Disadvantages of using Food Grate Stainless Steel Rods for Internal Fixation of Femoral Transverse Fractures in Rabbits (Review Study)

2020 ◽  
Vol 5 (2) ◽  
pp. 1-7
Author(s):  
Humam H Nazht
Keyword(s):  
Stainless Steel ◽  
Internal Fixation ◽  
Radiological Finding ◽  
Femoral Bone ◽  
Advantages And Disadvantages ◽  
Level Measurement ◽  
Stifle Joint ◽  
Intramedullary Canal ◽  
Chemical Constant ◽  
Transverse Fractures

The present study designed to focus on the advantages and disadvantages of using food grate stainless steel rods (FGSR) as internal fixation methods for induced transverse fractures in the mid shift of the femoral bones in rabbits.200 cases were collected from 2007 to 2020, all these cases were employed to induced transverse fractures in the mid shift of femoral bone, 100 of them used the rods for internal fixation, 80 of the cases used the rods for fixation the natural xen- bony implantation from sheep or calves, and the others 20 cases used the rods for internal fixation of the synthetics nano bony implantation .The physical, chemical, clinical and radiographic parameters were used for evaluation, the physical and chemical analysis showed that the rods not change during sterilization, implantation or when exposed to different types of ray besides the chemical constant is about the same level measurement of the medical intramedullary pins (IMP), while the clinical observation revealed that the rods can used strongly and successfully for fracture fixation and support the animal to bear the weight, the limb used for walking gradually after 24-48 hours p. o. with some cases shown the FGSR pulled from the bone, other suffer from infection with pus formation with lateral deviation of the stifle joint or re-fracture. While the radiological finding revealed that the FGSR insert and fix the fractures fragment and the bony implantation, the pins seemed stable and fit the intramedullary canal and fracture fragments, while some cases shows that the pin not insert properly inside the femoral bone with case of multible and comminuted fractures, other case shown the FGSR pass and penetrate the stifle joint. The conclusion is, there are many advantages with minor or very little disadvantages for using the FGSR as internal fixation of the induced transverse fractures in the mid shift of the femoral bones and for natural and synthetics bony implantation in rabbits.

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