Total_elbowreplacement

목차

HISTORICAL REVIEW

BIOMECHANICS OF THE ELBOW

INDICATIONS FOR ELBOW REPLACEMENT

CONTRAINDICATIONS TOTOTAL ELBOWREPLACEMENT

AVAILABLE TYPESOF ELBOW REPLACEMENT

COMPLICATIONSOF TER

SUMMARY: CONTROVERSIES INTER

REFERENCES

본문내용

The ¢rst elbowreplacementswere of a rigidhinge design and were introduced in the wake of the success of total hip replacementsd uring the 1970s. Occasional replacementso f various designs had been tried for exceptional cases prior to this. Alternatives to elbow replacement were two other formso f arthroplastyFexcisional and interpositional. To a certain extent these still are performed.
Excisional arthroplasty has a long history dating back to the early 19th century. Interpositional arthroplasty wasd eveloped in 1920 by McAusland. Several materials have been interposed including fat, dermis, muscle, capsule, fascia and synthetic materials. Currently Achilles tendon allograft is being used. The interposed tissue
may be protected for a period with the use of a hinged distraction frame, immobilisation of the elbowshould be avoided to minimise the risk of post-traumatic elbow sti¡ness.
Thesemethods of arthroplasty had variable outcomes in termso f pain relief and restoration of function and it is not surprising that surgeons turned to the new designs of total elbow replacement. Initially, excellent pain relief wasa chievedwith the hinged prostheses, but these ¢rst implantsw ere beset with complications, including ulnar nerve damage, fracture and implant failure. Rateso f
loosening up to 70%were reported,which led to the development
of semi-constrained prostheses. It was thought that transferring load from the bone ^ cement interface to the soft tissues would result in increased longevity.Thisha s been achieved to some extent and in the rest of this review paper we will outline the current
position in elbow replacement surgery.

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