A unique salvage operation strategy: implantation of the ulnar total elbow component to the radius to overcome large ulnar bone defect caused by infection after total elbow arthroplasty.

Abstract

The elbow joints of patients with rheumatoid arthritis (RA) are often destroyed, and total elbow arthroplasty (TEA) is one treatment for these patients. However, patients with RA tend to develop surgical site infections due to immunosuppression. Once an implant is infected, reoperation may be difficult because of the risk of reinfection. In such patients, the infected site must be debrided thoroughly, although this might reduce the bone scaffold needed for re-TEA. We used a unique method to manage a large ulnar bone defect and an infected implant. The patient with RA had undergone TEA 15 years earlier. Etanercept was initiated to control disease activity; however, this treatment led to infection of the elbow prosthesis. Several surgical debridements were performed to eradicate the bacteria, which improved the symptoms of infection. However, most of the proximal ulna was lost, and it seemed impossible to fix the prosthesis using the remaining small ulna after debridement. Therefore, we planned to implant the ulnar component into the radius as a salvage technique. With this procedure, we provided the patient with elbow mobility and eradicated the infection. This is an alternative method for restoring function in an elbow with a massive bone defect in the ulna.

• Authors: Takuya Tomizawa, Hiromu Ito, Koichi Murata, Shuichi Matsuda
• Journal: Modern rheumatology case reports (Mod Rheumatol Case Rep) Vol. 6 Issue 1 Pg. 115-119 (Jan 07 2022) ISSN: 2472-5625 [Electronic] England
• PMID: 34499143 (Publication Type: Journal Article, Case Reports)
• Copyright: © Japan College of Rheumatology 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected].

Topics

• Arthroplasty, Replacement, Elbow (adverse effects)
• Elbow
• Elbow Joint (diagnostic imaging, surgery)
• Humans
• Radius (surgery)
• Ulna (diagnostic imaging, surgery)