This document discusses total elbow arthroplasty. It provides an overview of the different types of elbow implants, including fully constrained, semi-constrained, and unconstrained designs. Semi-constrained implants are most commonly used. Patient selection criteria and contraindications are outlined. Post-operative care involves restricting motion and weight-bearing initially. Common complications include instability, polyethylene wear, osteolysis, loosening, and infection. Revision surgery may be needed in cases of painful or failed elbow replacements.
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
Elbow Replacement surgery & Treatment || Medicyatra Surgerica
MedicYatra provides the safe & best Elbow Replacement Surgery @ $4,356, at its affiliate & trusted Orthopedic hospitals & clinics in various metro cities of India, like Mumbai, Delhi, Bangalore, Chennai, Pune etc.Our Associate Board certified Orthopedic surgeons are extensively trained and vastly experienced and have performed hundreds of such surgeries at our state of the art JCI accredited hospitals & Clinics. Our aim is to provide you the best of the services at the most affordable costs. Don't forget to say hi at info@medicyatra.com
Deformity: It’s the position of a limb/Joint, from which it cannot be brought back to its normal anatomical position.
Described as abnormalities of :
Length
Angulation
Rotation
Translation
Combination
Elbow Replacement surgery & Treatment || Medicyatra Surgerica
MedicYatra provides the safe & best Elbow Replacement Surgery @ $4,356, at its affiliate & trusted Orthopedic hospitals & clinics in various metro cities of India, like Mumbai, Delhi, Bangalore, Chennai, Pune etc.Our Associate Board certified Orthopedic surgeons are extensively trained and vastly experienced and have performed hundreds of such surgeries at our state of the art JCI accredited hospitals & Clinics. Our aim is to provide you the best of the services at the most affordable costs. Don't forget to say hi at info@medicyatra.com
Elbow arthroplasty associated with distal humerus fracture -spanish - HovsepianJean Michel Hovsepian
Orthopaedic Surgery Residency Presentation from Universidad Central de Venezuela, Hospital Universitario de Caracas. Seminar about Elbow arthroplasty associated with distal humerus fracture: Biomechanics, Types, Indication, Surgical Procedure, Justification, Complications. Jean Michel Hovsepian. Material in Spanish.
i prepared this presentation for our hospital monthly clinicopathological conference. our experience with TKR is not so vast but v are satisfied with what v have done till date.
Can read freely here
https://sethiortho.blogspot.com/
Challenges and Solutions in
Management of Distal Humerus Fractures
Epidemiology
Anatomy
Classification
Controversies and Recent studies
Approach
Implants selection
Plate configuration
Ulnar nerve transposition
Role of total elbow arthroplasty in DHF
Role of hemiarthroplasty in DHF
Metaphyseal comminution –
Anatomic complexity of the distal humerus
Positioning of the plates
TBW –
Skin closure
Osteoporotic nature of the bone –
Less BMD/Thin metaphysis
Screw Pullout strength is low
DHF account for 2% of all adult fractures
The common pattern of fracture
Intraarticular and involves both columns
Bimodal distribution
Peak incidence in young male and in older female patients
Young male – High-velocity injury
Older female - Osteoporosis
The distal humerus is flattened and expanded bony structure
It is composed of lateral and medial columns with the trochlea situated between these columns.
The location of the trochlea is central rather than medial
Formed by Medial SCR + M/Epicondyle
The distal end has 450 angulation with humeral shaft
M/ Epicondyle gives attachment for MCL & Common Flexor Origin
The MCL originates from the undersurface of the medial epicondyle where it is vulnerable to excessive dissection
Ulnar nerve
Formed by Lateral SCR and L/Epicondyle and Capitulum
Distal end has 200 with humeral shaft
L/ epicondyle gives attachment for LCL & common extensor origin
Its posterior surface is non articular and can be used as a site for a plate fixation
The lateral column curves anteriorly
Placement of a straight plate on the posterolateral surface of the humerus risks straightening of distal humerus.
The medial column including the medial epicondyle is in line with the humeral shaft.
It forms the center of the triangle
It has 30 - 80 – external rotation & 250 anterior divergent with the shaft
It forms a 40 - 80 degree valgus direction
X-ray -
Anterior-posterior view
lateral View
Traction View – This can help to define articular fragments and aid in pre-operative classification of the fracture.
NCCT – Elbow
Articular surfaces
Position of the fracture fragments
useful for identifying impacted fracture fragments that make reduction challenging
Olecranon Osteotomy Approach – 52-57%
Triceps sparing VS Olecranon osteotomy approach
The lateral column was often the first to fail as a result of excessive varus forces acting on the elbow during normal activities of daily living. Small anterior-posterior diameter
Smaller diameter of the humerus, permitting only one or two short screws for fixation.
Interruption of blood supply to the lateral column
blood supply to the lateral column is also derived from posterior segmental vessels. Sagittal plane plating has less risk of injuring these structures, which may improve the chances of union
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
2. INTRODUCTION
Elbow arthroplasty has been described in multiple forms
over time.
Semi-constrained total elbow arthroplasty, in particular, has
a well-studied track record
However, the procedure is associated with a relatively high
complication rate
Not durable as replacements of the hip, knee, or shoulder
In particular, the excessive loads placed on the device by
high-demand patients is a common cause of failure.
3. GOAL OF TOTAL ELBOW
ARTHROPLASTY
Restore functional mechanics of elbow
Relief of pain
Restoration of motion
Stability
4. IMPLANT TYPES
• Depending on rigidity of fixation of humeral
component to ulnar component
• FULLY CONSTRAINED
• SEMI CONSTRAINED
• UNCONSTRAINED
5. FULLY CONSTRAINED
• Metal to metal hinge with PMMA cement
fixation
• Rarely used now as they have tendency to
loosen & breakage
• Eg: stanmoore.Dee,Mckee.GSB1 & Mazas
designs
6. SEMI CONSTRAINED
• 2 or 3 part prosthesis
• Metal to high density polyethylene
articulation connected with locking
pin or snap-fit device
• Have built in Valgus & varus laxity
for side to side dissipation of forces
• Eg: Coonrad, Mayo, Tri-axial,
Schlein, AHSC Pritchard-walker
7. UNCONSTRAINED
• 2 part prosthesis
• Metal to high density polyethylene articulation without
locking pin or snap-fit link
• Design consists of - stems for humeral component or
resurfacing devices
• Parts unlinked in a attempt to anatomically duplicates
the articular surface of the elbow
• Require normal intact ligaments, anterior
capsule & appropriate static alignment
8. PATIENT SELECTION
It is the most definitive functional procedure for
END STAGE ELBOW ARTHRITIS
• End stage-Rheumatoid Arthritis with radiological
evidence of joint destruction
• Acute unreconstructable fracture > 60 age
• Bilateral elbow ankylosis
• Bony or fibrous ankylosis with elbow in poor functioning
position
9. Contd…
• As a revision of failed elbow arthroplasty
• Loss of bone stock caused by tumour/trauma
• End stage –Osteoarthritis
• Post traumatic arthritis
• Nonunion of distal humerus
• Hemophilic arthropathy
10. IMPLANT SELECTION
Depends to a great extend on the
Fate of capsuloligamentous structures about the elbow
Integrity of the musculature
Amount of bone remaining at the elbow joint
• Resurfacing /unconstrained prosthetic designs-patients with
a more stable joint with more bone remaining
• Semi-constrained- patients with extensive injury to ligaments
& capsule of joint, atrophic musculature & loss of considerable
bone stock
11. CONTRAINDICATIONS
• Active or recent elbow Sepsis(absolute)
• Poor soft tissue envelope
• Non restorable function of Biceps & Triceps
• Poor patient compliance with activity & weight lifting
restrictions
• Flaccid paralysis of upper extremity
• Young vigorous patient with a post traumatic destroyed elbow
• Neuropathic elbow joint
• Ankylosis of Ipsilateral shoulder
12. PRE-OP PLANNING
• Routine AP & lateral radiographs
Assess humeral bow & medullary canal size in
lateral projection
Note size & angulation of the ulnar medullary canal
In both projection
• Templates are available for all the varying size prostheses &
very useful
• Ulnar nerve examination-document if any degree of
impairment noted
• Elbow aspiration & culture to rule out joint sepsis –if infection
is suspected or rheumatoid elbow is red/hot/swollen
13. COONRAD-MORREY PROSTHESIS
• Semi-constrained hinged prosthesis
• High-molecular-weight polyethylene bushing & titanium
humeral and ulnar components.
• Designed with 7 * of rotary and side-to-side laxity.
• Humeral and ulnar stems match the shapes of the
medullary canals.
• The triangular humeral stem is flattened near the base at
the inferior flatter and wider portion of the medullary canal
of the humerus.
14. • The large medullary stem enhances rigid fixation.
• Its long stem, contour & distal anterior flange increase
resistance to torque.
• Careful bone removal in the intercondylar area of the
humerus is necessary to allow a tight fit of the humeral
prosthesis.
• Prosthesis usually is inserted with the elbow fully flexed
• Components also can be inserted separately and then
joined.
• Right & left prostheses are available as trial components.
15.
16.
17.
18. POST OP IMAGING
• AP and lateral films are obtained as baseline reference
• used for future comparison to follow up studies to document
stability of prosthesis.
• Initial radiographs are scrutinized for:
• Alignment
▫ Humeral and ulnar stems should align with the long axis of
the bone
▫ Humeral and ulnar components show normal articulation
without evidence of dislocation
19. • Peri-prosthetic fractures
• Cement technique
▫ Cement should coat the prosthesis stems without
extravasation into soft tissues
▫ Intraoperative fractures or osteopenic bone increase risk
of cement leak which may damage radial or ulnar
nerves.
20. POST OP CARE
The extremity is elevated overnight with elbow above
the shoulder.
The drains & compressive dressing are removed the day
after surgery.
A light dressing is then applied & passive elbow flexion
and extension are allowed as tolerated.
A collar and cuff are used & instructions in the activities
of daily living are provided by an occupational therapist.
21. Active elbow extension must be avoided for
3 months until the triceps heals.
Strengthening exercises are avoided.
Patient is encouraged to avoid lifting more than
5 lb for the first 3 months after surgery
Thereafter, lifting is restricted to 10 pounds
22. RESULTS
• RATING SYSTEM OF MORREY
used 3 criteria to rate TEA
Xray appearance
pain
motion
1.GOOD RESULT
No radiographic change at the bone cement /prosthesis
interface
No pain
>90* of flexion
60* of pronation & supination
23. 2.FAIR RESULTS
• > 1mm of widening of any bone cement prosthesis
interface
• Mild pain
• Between 50* & 90* of flexion & extension
• Less than 40* of pronation & supination
3.POOR RESULTS
• >2mm of widening of any bone cement prosthesis
interface
• Pain that significantly limits activity
• Less than 50* of flexion & extension
• Revision of elbow arthroplasty
24.
25. PAINFUL OR FAILED ELBOW
ARTHROPLASTY
• Evaluated with serial conventional radiographs
• May be due to a variety of problems. These include:
• Instability
• Polyethylene problems
• Osteolysis
• Loosening
• Infection
• Fractures
• Heterotopic ossification
26.
27. INSTABILITY
• Instability occurs in the form of dislocation or subluxation
• Most common complication requiring revision of
unconstrained prostheses
• reported to occur in between 9% and 10% of total elbow
arthroplasties
INTRA-OP PRECAUTIONS
• Appropriate tensioning of the medial & lateral ligament
complexes
• preservation of the anterior capsule and triceps
28. INSTABILITY
• Instability in SEMI-CONSTRAINED TEA is usually caused
by
wear of the polyethylene bushings or
disengagement of the linkage pin.
• Proper prosthesis alignment is crucial in linked
arthroplasty.
• Malalignment can cause abnormal forces to be generated
across the joint which can lead to early hardware failure.
29. Polyethylene Problems
• Polyethylene components are prone to wear after long
term usage.
• Wear and the subsequent debris that it produces initiate
synovitis and foreign body reaction, which can ultimately
lead to severe bone loss.
• In many linked arthroplasty prostheses models,
bushings are made of polyethylene.
• A bushing is defined as a fixed or removable cylindrical
lining used to reduce friction between the humeral and
ulnar components.
30. Polyethylene Problems
• Bushing wear is determined on an AP radiograph.
METHOD:
• A line was drawn parallel to the yoke of the humeral
component, & another line was drawn parallel to the
medial or lateral surface of the ulnar component.
INFERENCE :
• An angle of intersection > 7 * indicates excessive tolerance
of the bushings due to polyethylene deformation
31. Polyethylene Problems
• Certain factors are associated with the development
of bushing wear. They are
• younger patient age,
• male sex,
• Post traumatic arthritis,
• Pre operative elbow deformity,
• Supra condylar nonunion,
• high activity levels
32. Osteolysis
• Refers to both focal and linear periprosthetic bone loss
adjacent to any joint replacement
• Results from a foreign body response to particulate debris
from the wear of arthroplasty components and cement
• Particles are taken up by macrophages & giant cells which
may release cytokines that initiate a cascade reaction
ultimately resulting in osteolysis
33. • Osteolysis is usually asymptomatic.
• Follow-up radiographs are used to identify the
process early
• Thinned cortex and weakened bone places patients at
risk of pathologic fracture, prosthesis subsidence and
loosening
• Large amounts of particulate may dissolve in joint
fluid, staining the fluid and synovium a dark metallic
color. This is called metallosis
34. Aseptic Loosening
• Failure of the bond between an implant and bone in the
absence of infection.
• It is the most frequent cause of long-term implant failure
RISK FACTORS:
patients who continue to use their elbow in
strenuous activities and heavy lifting
constrained, linked prosthesis types.
• Presents with insidious onset of activity related pain in a
previously well functioning prosthesis.
35. Aseptic Loosening
Radiographic signs of loosening include:
Progressive and extensive widening of interfaces
between bone-cement, bone-prosthesis, or cement-prosthesis
Fragmentation or fracture of cement
Migration/subsidence of prosthetic components
Bead shedding in porous-coated prostheses
36. Marked loosening of humeral stem with migration
antero-laterally beyond the humeral cortex.
37. INFECTION
• Infection rates after TEA remain greater than those for total
hip or knee arthroplasties.
• Reason:
relative paucity of soft tissue coverage in the
elbow compared to the other joints.
• Typical infecting organisms are
Staphylococcus aureus ,
Staphylococcus epidemidis
38. INFECTION
• Risk factors : oral steroid use, diabetes mellitus, distant
osteomyelitis, infected prostheses at other sites &
H/O septic arthritis in the affected elbow.
Clinical signs and symptoms may consist of
• Pain
• Decreasing range of motion
• Fever
• Night sweats
• Chills
• Erythema
• Draining sinus tract
39. Radiographic features of infection include:
• Progressive and extensive widening of interfaces
between bone-cement, bone-prosthesis or cement-prosthesis
• Periosteal bone formation
• Periprosthetic bone resorption
• Soft tissue or periprosthetic gas
40. Infected total elbow arthroplasty. There is a large joint effusion (red arrow),
distended olecranon bursa (O), and irregular interface widening about the
ulnar stem (green arrow).
41. INFECTION
• Infection of elbow replacements requires aggressive
treatment with Antibiotics
Surgical management may consist of:
• Irrigation and debridement
▫ Considered when infection is acute
▫ May require repeat procedures, placing patient at risk for
soft-tissue damage
• Resection arthroplasty
▫ Hardware removed and antibiotic impregnated cement
space placed
▫ Eventually followed by revision arthroplasty
42. • Cement spacers are temporary prostheses made of
antibiotic impregnated methylmethacralate.
• The cement is prepared in the surgical site, mixed with
antibiotics, and formed by the surgeon into forms
resembling the components of the elbow arthroplasty.
Advantages :
• Provide local dispersal of antibiotics to the infected joint
area
• Maintain length
• Minimize dead space
• Preserve soft-tissue planes
• Facilitate ease of revision arthroplasty
43. PERIPROSTHETIC FRACTURES
• The rate of periprosthetic fractures after elbow arthroplasty vary
from 6% to 22%
• Classified using Mayo classification of periprosthetic
fractures after elbow arthroplasty
Fractures are classified according to
• location
• bone quality
• whether component is stable or loose
• Classification of the humerus and ulna are determined
separately.