Patellofemoral Arthroplasty: A Technical Note.

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Abstract

Conflict of interest statement: One or more of the authors has declared the following potential conflict of interest or source of funding: N.N.V. is on the board or committee for American Orthopaedic Society for Sports Medicine, American Shoulder and Elbow Surgeons, and Arthroscopy Association of North America; is a paid consultant for Arthrex, Inc, and Stryker; received research support from Arthrex, Inc, Breg, Ossur, Smith & Nephew, and Wright Medical Technology, Inc.; received stock or stock options from Cymedica, and Omeros; is on the Editorial or governing board for SLACK Incorporated; received IP royalties from Smith & Nephew; and received publishing royalties, financial or material support from Vindico Medical-Orthopedics Hyperguide. J.C. is on the board or committee for American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, and International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine; is a paid consultant for Arthrex, Inc., CONMED Linvatec, Ossur, and Smith & Nephew. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. 17. J Hand Surg Asian Pac Vol. 2023 Aug;28(4):479-485. doi: 10.1142/S2424835523500558. Epub 2023 Sep 25. Outcomes of Revision Unlinked Total Elbow Arthroplasty for Rheumatoid Elbow. Kodama A(1)(2), Mizuseki T(1), Adachi N(2). Author information: (1)Department of Orthopaedic Surgery, Hiroshima Prefectural Rehabilitation Center, Taguchi, Saijo, Higashihiroshima, Hiroshima, Japan. (2)Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, Japan. Background: Although unlinked total elbow arthroplasty (TEA) is a treatment option for end-stage rheumatoid arthritis (RA) of the elbow, its long-term outcomes were inferior. Moreover, revision TEA could be technically challenging. The unlinked TEA procedure comprises the ease of implant removal at revision and advantage of bone preservation. This study evaluated the clinical outcomes in patients who underwent revision TEA using primary unlinked TEA for rheumatoid elbows. It also aimed to determine whether selecting the unlinked prosthesis for the primary TEA would make revision more accessible and successful. Methods: We retrospectively reviewed data of 13 consecutive patients (14 elbows) who underwent revision TEAs for implant failure due to different aetiologies, excluding septic loosening. Three different unlinked TEA implants were used: the Kudo type-5 with all-polyethylene (AP) ulnar component, Kudo type-5 with metal-backed (MB) ulnar component and K-Now TEA. We evaluated the patients' pre- and postoperative outcomes, including the range of motion, pain score and Mayo Elbow Performance Index (MEPI). Results: Among the 14 elbows, 11 were revised using the Kudo type-5 ulnar component (nine and two with AP and MB ulnar component, respectively), and three using the K-Now. We found that each model of TEA had different tendencies to indication for revision surgery. Three more resulted in further failure. The clinical outcomes were assessed in the 11 surviving elbows. Eight of the 11 elbows showed no pain at the final follow-up. However, the remaining three showed only mild pain. The MEPI revealed that seven cases were excellent, two were good and two were fair. Conclusions: The mode of implant failure was largely dependent on the implant design. Furthermore, partial revision with the same implant design was sufficient in managing implant failure in the early phase. However, conversion from unlinked to linked design could be recommended in patients with progressive failure or instability. Level of Evidence: Level IV (Therapeutic). DOI: 10.1142/S2424835523500558