Does the triceps-on approach affect alignment in total elbow arthroplasty? A cadaveric study.

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Arthroplasty

Background:

• The triceps-on approach for total elbow arthroplasty aims to preserve the extensor mechanism.
• Concerns exist regarding potential reductions in surgical exposure and implant alignment with the triceps-on approach compared to the triceps-off method.

Purpose of the Study:

• To compare the implant alignment achieved using the triceps-on versus triceps-off approach in total elbow arthroplasty.
• To evaluate potential differences in component positioning accuracy between the two surgical approaches.

Main Methods:

• Eighteen paired cadaveric elbows underwent total elbow arthroplasty using either the triceps-on or triceps-off approach.
• Implant positions were measured relative to anatomical landmarks, including flexion/extension, varus/valgus angles, and rotational alignment.

Main Results:

• No significant differences in implant alignment were observed between the triceps-on and triceps-off groups.
• Seven components in total exhibited alignment deviations greater than 5° from the ideal, with no statistically significant variation between the approaches.

Conclusions:

• The triceps-on approach for total elbow arthroplasty does not lead to greater alignment errors in component positioning.
• These findings support the theoretical benefits of the triceps-on approach without compromising surgical accuracy.