Elbow joint loads during simulated activities of daily living: implications for formulating recommendations after total elbow arthroplasty

Review written by Dr Val Jones info

Key Points

  1. Elbow replacements often need revision surgery, due to aseptic loosening, which has been linked to overloading of the prosthesis.
All key points available for members only

BACKGROUND & OBJECTIVE

Total elbow arthroplasty (TEA) is a relatively uncommon procedure, aimed at reducing pain and improving function in conditions such as inflammatory arthritis or complex fractures in elderly patients. Unfortunately, elbow implant survival is not as long (1), when compared with hip and knee prosthesis, making the possibility of revision surgery, and its increased risk profile, more likely.

The most common cause for revision surgery is aseptic loosening of the implant, with overloading of the implant and polyethylene wear during activities of daily living being thought of as a common cause. Many surgeons therefore limit lifelong loading of the prosthesis to 1 kg on a regular basis, and 5kg on rare occasions in the hand on the affected side, or its equivalent in forces generated at the implant site. However, there is a paucity of research informing patients and clinicians which activities of daily living equate to these forces, which has led to a call from clinicians to make this subject a research priority in elbow conditions (2).

The aims of the current study were to explore elbow joint forces across a range of activities, and to ascertain whether elbow joint position during these tasks has an impact on peak loads at the elbow joint.

Elbow implant survival is not as long when compared with hip and knee prosthesis, making the possibility of revision surgery more likely.
bulb
The elbow range needed to perform everyday activities echoes other studies, which highlights the importance of end of range flexion motion rather than full extension.

METHODS

Nine healthy participants undertook a series of eight laboratory simulated activities of daily living including:

to unlock full access to this review and 989 more