Proprioceptive deficit after total elbow arthroplasty: an observational study

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Neuroscience

Background:

• Total elbow arthroplasty (TEA) involves significant joint capsule removal, potentially compromising mechanoreceptors crucial for proprioception.
• Proprioceptive deficits post-TEA can hinder functional recovery and limit patient outcomes.

Purpose of the Study:

• To quantify proprioceptive loss after unilateral TEA by measuring the threshold to detection of passive motion (TTDPM).
• To compare TTDPM between the operated elbow and the contralateral, non-operated elbow.

Main Methods:

• Eight patients (mean age 69.1 years) underwent TTDPM assessment at least one year after unilateral semiconstrained linked TEA.
• A continuous passive motion device evaluated TTDPM at a slow velocity (0.5°/s).
• Elbow function was assessed using the Mayo Elbow Performance Scale.

Main Results:

• Patients with TEA showed significantly higher TTDPM (15.6 ± 6.9 seconds) compared to their contralateral elbows (7.2 ± 2.6 seconds), indicating substantial proprioceptive deficit.
• The difference in TTDPM was statistically significant (P=.01), averaging 8.4 seconds.
• Mayo Elbow Performance Scale scores indicated 4 excellent, 2 good, and 2 poor outcomes post-surgery.

Conclusions:

• Semiconstrained TEA leads to long-term proprioception deficits in patients with severe joint disease.
• More conservative surgical techniques that preserve soft tissues and insertions may mitigate upper limb proprioceptive deficits.