ARTT Approach to Total Elbow Arthroplasty Devised for Post-Trauma Patients: Preliminary Results

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Trauma Reconstruction

Background:

• Total elbow arthroplasty (TEA) is increasingly performed in trauma patients.
• Traditional approaches face challenges in post-trauma cases due to scar tissue and bone deformity.
• The Anconeus-reflected Triceps tongue (ARTT) approach was developed to address these challenges.

Purpose of the Study:

• To describe the ARTT surgical technique for TEA.
• To discuss the advantages of the ARTT approach, particularly in post-trauma patients.
• To report the preliminary outcomes of the ARTT approach in complex cases.

Main Methods:

• The ARTT approach involves reflecting the anconeus and triceps muscles as one, sparing the triceps tendon insertion.
• Six consecutive patients with severe elbow malunion and previous surgeries underwent TEA using the ARTT technique.
• Data collected included functional scores and triceps tendon integrity.

Main Results:

• Mean follow-up was 29 months.
• Mayo Elbow Performance Score improved from 39 to 95.
• Visual analog pain score decreased from 7.5 to 1.
• No triceps tendon insufficiency or detachment occurred.
• All patients achieved Medical Research Council grade 4 or 5 strength.

Conclusions:

• The ARTT approach provides enhanced joint exposure and preserves triceps tendon insertion.
• This technique facilitates earlier active rehabilitation.
• Preliminary results suggest the ARTT approach is a viable alternative for post-trauma patients with severe elbow dysfunction.