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Triceps insufficiency following total elbow arthroplasty.
Andrea Celli1, Araghi Arash, Robert A Adams
1Mayo Clinic, 200 First Street S.W., Rochester, MN 55905, USA.
The Journal of Bone and Joint Surgery. American Volume
|September 6, 2005
Summary
Reconstructing the triceps tendon after total elbow arthroplasty can restore elbow extension. Surgical techniques vary, but most patients achieve good outcomes, highlighting the importance of procedure selection.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Biomechanics
Background:
- Total elbow arthroplasty indications have risen, increasing the incidence of triceps tendon insufficiency.
- Triceps tendon rupture or avulsion is a recognized complication of total elbow arthroplasty.
- Limited literature exists on managing triceps insufficiency post-total elbow arthroplasty.
Purpose of the Study:
- To review management options for triceps insufficiency following total elbow arthroplasty.
- To evaluate the outcomes of surgical intervention for triceps insufficiency.
- To identify factors influencing successful triceps reconstruction.
Main Methods:
- Retrospective review of 887 total elbow arthroplasties (1982-2001).
- Identified 16 elbows in 14 patients with triceps insufficiency (excluding infection-related cases).
- Assessed outcomes using Mayo Elbow Performance Score and elbow extension strength.
Main Results:
- Three repair techniques were used: direct suture (7 elbows), anconeus rotation (4), and Achilles tendon allograft (4).
- Elbow extension against gravity was restored in 15 of 16 elbows.
- Outcomes were excellent in 11 elbows, good in 3, and failure in 2.
Conclusions:
- Triceps mechanism reconstruction is feasible following total elbow arthroplasty.
- Successful outcomes depend on selecting the appropriate procedure based on tissue quality, tendon retraction, and olecranon status.
- Surgical reconstruction can effectively restore extensor function and improve patient outcomes.