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Strength function after elbow arthroplasty.

B F Morrey1, L J Askew, K N An

  • 1Department of Orthopaedics, Mayo Clinic, Rochester, MN 55905.

Clinical Orthopaedics and Related Research
|September 1, 1988
PubMed
Summary
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Total elbow joint arthroplasty significantly improved flexion, pronation, and supination strength. While grip strength saw moderate gains, extension strength did not improve, with specific prosthetic placements and surgical approaches impacting outcomes.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Rehabilitation Medicine

Background:

  • Total elbow joint arthroplasty (TEJA) is a reconstructive procedure for severe elbow dysfunction.
  • Assessing functional strength recovery post-TEJA is crucial for patient outcomes and surgical technique refinement.

Purpose of the Study:

  • To prospectively evaluate elbow strength changes after total elbow joint arthroplasty.
  • To identify factors influencing strength recovery, including diagnosis, prosthetic alignment, and surgical approach.

Main Methods:

  • Prospective study involving 27 patients (31 TEJA procedures).
  • Measurement of pre- and post-operative elbow flexion, extension, pronation, supination, and grip strength.
  • Analysis of strength outcomes based on diagnosis (rheumatoid vs. non-rheumatoid arthritis), prosthetic axis placement, and surgical approach (triceps-sparing vs. others).

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Main Results:

  • Significant improvements observed in flexion (92%), pronation (63%), and supination (69%) strength.
  • Grip strength improved by 35%; no mean improvement in extension strength.
  • Rheumatoid arthritis patients showed greater average strength improvement (71%) than non-rheumatoid (25%).
  • Prosthetic axis placement deviating from the normal axis correlated with poorer strength outcomes.
  • Triceps-sparing approach demonstrated better extension strength recovery (20%) compared to other exposures.

Conclusions:

  • Total elbow joint arthroplasty can restore significant elbow function, particularly flexion and rotation.
  • Prosthetic alignment and surgical technique, such as the triceps-sparing approach, are critical factors influencing strength recovery, especially in extension.
  • Further research with larger sample sizes is needed to compare different prosthetic types.