Advertisement

Total Elbow Arthroplasty in Rheumatoid Arthritis and Other Inflammatory Conditions: Unlinked or Linked Replacement?

  • Alessandra Colozza
  • Luigi Perna
  • Alberto Trimarchi
  • Bernard F. Morrey
Chapter

Abstract

Many conditions can affect the elbow and lead to arthroplasty, including rheumatoid arthritis, juvenile rheumatoid arthritis, spondyloarthropathies, crystalline-induced arthropathies and adult Still’s disease. In this chapter, the authors describe the pathophysiology, clinical presentation and treatment of these different conditions, also named “inflammatory pathologies”, with a focus on surgical treatment. In particular, clinical recommendations on the choice of implant to best match the pathoanatomic pattern of this wide spectrum of pathologies are made based on a thorough review of the literature. The implants commonly used can be linked, unlinked or convertible. Implant selection is based on bone stock quality and collateral ligament and muscular tissue effectiveness. The aim is to achieve pain relief, functional arc of motion and a stable joint with a high survival rate. If the surgical technique is correct, total elbow arthroplasty (TEA) performed by expert surgeons can lead to excellent outcomes in accurately selected patients.

Keywords

Total elbow arthroplasty Inflammatory arthropathy Rheumatoid arthritis Juvenile rheumatoid arthritis Spondyloarthropathy 

References

  1. 1.
    Stastny P. The association of B-cell alloantigen DRw4 with rheumatoid arthritis. N Engl J Med. 1978;298:869.CrossRefPubMedGoogle Scholar
  2. 2.
    Souter WA. Surgery of the rheumatoid elbow. Ann Rheum Dis. 1990;49(Suppl 2):871–82.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988;31:315.CrossRefGoogle Scholar
  4. 4.
    Fahalli S, Halla JT, Hardin JG. Onset patterns of rheumatoid arthritis. Clin Res. 1983;31:650A.Google Scholar
  5. 5.
    Willims GR, Yamaguchi K, Ramsey ML, Galatz LM. Arthroplasty in synovial-based arthritis of the elbow in shoulder and elbow Arthroplasty PA. Philadelphia: Lippincott Willimas & Wiilkins; 2005. p. 381–9.Google Scholar
  6. 6.
    Connor PM, Morrey BF. Total elbow arthroplasty in patients who have juvenile rheumatoid arthritis. J Bone Joint Surg. 1998;80A:678.CrossRefGoogle Scholar
  7. 7.
    Morrey BF. Semiconstrained total elbow replacement. In: Morrey BF, Thompson Jr RC, editors.. (series ed.) The elbow. Master techniques in orthopaedic surgery. New York: Raven Press; 1994. p. 231–55.Google Scholar
  8. 8.
    Lee BP, Morrey BF. Arthroscopic synovectomy of the elbow for rheumatoid arthritis. A prospective study. J Bone Joint Surg Br. 1997;79(5):770–2.CrossRefPubMedGoogle Scholar
  9. 9.
    Horiuchi K, Momohara S, Tomatsu T, Inoue K, Toyama Y. Arthroscopic synovectomy of the elbow in rheumatoid arthritis. J Bone Joint Surg Am. 2002;84A(3):342–7.CrossRefGoogle Scholar
  10. 10.
    Kauffman JI, Chen AL, Stuchin S, Di Cesare PE. Surgical management of the rheumatoid elbow. J Am Acad Orthop Surg. 2003;11(2):100–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Steinmann SP, King GJ, Savoie FH 3rd. American academy of orthopaedic surgeons. arthroscopic treatment of the arthritic elbow. J Bone Joint Surg Am. 2005;87(9):2114–21.CrossRefPubMedGoogle Scholar
  12. 12.
    Marsh JP, King GJ. Instr unlinked total elbow arthroplasty. Course Lect. 2015;64:231–42.Google Scholar
  13. 13.
    Little CP, Graham AJ, Carr AJ. Total elbow arthroplasty: a systematic review of the literature in the English language until the end of 2003. J Bone Joint Surg Br. 2005;87(4):437–44.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Sanchez-Sotelo J, Baghdadi YM, Morrey BF. Primary linked semiconstrained total elbow arthroplasty for rheumatoid arthritis: a single-institution experience with 461 elbows over three decades. J Bone Joint Surg Am. 2016;98(20):1741–8.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Morrey B. Linked elbow arthroplasty: rational, indications, and surgical technique. In: Morrey “the elbow and its disorders”. 4th ed. Philadelphia: Saunders; 2008. p. 765–81.Google Scholar
  16. 16.
    Graham K. Unlinked total elbow arthroplasty. In: Morrey “the elbow and its disorders”. 4th ed. Philadelphia: Saunders; 2008. p. 738–54.Google Scholar
  17. 17.
    Morrey B. Total elbow arthroplasty for juvenile rheumatoid arthritis. In: Morrey “the elbow and its disorders”. 4th ed. Philadelphia: Saunders; 2008. p. 792–9.Google Scholar
  18. 18.
    Fernandez-Palazzi F, Rodriguez J, Oliver G. Elbow interposition arthroplasty in children and adolescents: long-term follow-up. Int Orthop. 2008;32(2):247–50.CrossRefPubMedGoogle Scholar
  19. 19.
    Baghdadi YM, Jacobson JA, Duquin TR, Larson DR, Morrey BF, Sanchez-Sotelo J. The outcome of total elbow arthroplasty in juvenile idiopathic arthritis (juvenile rheumatoid arthritis) patients. J Shoulder Elb Surg. 2014;23(9):1374–80.CrossRefGoogle Scholar
  20. 20.
    Resnick D. Patterns of peripheral joint disease in ankylosing spondylitis. Radiology. 1974;110:523.CrossRefPubMedGoogle Scholar
  21. 21.
    McHugh NJ, Balachrishnan C, Jones SM. Progression of peripheral joint disease in psoriatic arthritis: a 5-yr prospective study. Rheumatology (Oxford). 2003;42:778.CrossRefGoogle Scholar
  22. 22.
    Orchard TR, Wordsworth BP, Jewell DP. Peripheral arthropathies in inflammatory bowel disease: their articular distribution and natural history. Gut. 1988;42:387.CrossRefGoogle Scholar
  23. 23.
    Morrey B. Seronegative inflammatory arthritis. In: Morrey “the elbow and its disorders”. 4th ed. Philadelphia: Saunders; 2008. p. 1039–42.Google Scholar
  24. 24.
    Hughes JS. Distal humeral hemiarthroplasty. In: Morrey “the elbow and its disorders”. 4th ed. Philadelphia: Saunders; 2008. p. 720–9.Google Scholar
  25. 25.
    MacDermid KA, Patterson SD, Regan WD, MacDermid JC, King GJ. Functional outcome of semiconstrained total elbow arthroplasty. J Bone Joint Surg Am. 2000;82-A(10):1379–86.Google Scholar
  26. 26.
    Nilsson OS, Persson PE. Heterotopic bone formation after joint replacement. Curr Opin Rheumatol. 1999;11(2):127–31.CrossRefPubMedGoogle Scholar
  27. 27.
    Barthelemy CR, Nakayama DA, Carrera GF, Lightfoot RW Jr, Wortmann RL. Gouty arthritis: a prospective radiographic evaluation of sixty patients. Skelet Radiol. 1984;11(1):1–8.CrossRefGoogle Scholar
  28. 28.
    Hadler NM, Franck WA, Bress NM, Robinson DR. Acute polyarticular gout. Am J Med. 1974;56:715.CrossRefPubMedGoogle Scholar
  29. 29.
    Resnick D, Niwayama G, Goergen TG, Utsinger PD, Shapiro RF, Haselwood DH, Wiesner KB. Clinical, radiographic and pathologic abnormalities in calcium pyrophosphate dihydrate deposition disease (CPPD): pseudogout. Radiology. 1977;122(1):1–15.CrossRefPubMedGoogle Scholar
  30. 30.
    Orzechowsky NM, Mason TG. Seronegative inflammatory arthritis. In: Morrey “the elbow and its disorders”. 4th ed. Philadelphia: Saunders; 2008. p. 1039–42.Google Scholar
  31. 31.
    Efthimiou P, Paik PK, Bielory L. Diagnosis and management of adult onset Still’s disease. Ann Rheum Dis. 2006;65:564.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Alessandra Colozza
    • 1
  • Luigi Perna
    • 1
  • Alberto Trimarchi
    • 1
  • Bernard F. Morrey
    • 2
    • 3
  1. 1.Department of OrthopaedicsFaenza HospitalFaenzaItaly
  2. 2.Department of OrthopaedicsMayo Clinic RochesterRochesterUSA
  3. 3.University of Texas Health Science CenterSan AntonioUSA

Personalised recommendations