Functional Outcomes of Patients with Ankylosed Elbow Managed with Fascia Lata Interposition Arthroplasty and Early Post-operative Active Motion Protocol A Retrospective Study
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Abstract
Background. Interposition arthroplasty is a non-prosthetic-requiring surgery that restores motion in young patients with ankylosed elbows who are not amenable to total elbow arthroplasty, elbow arthrodesis, or resection arthroplasty. This procedure usually requires extensive soft tissue stripping to free the elbow joint, an interposition graft, and post-operative immobilization.
Objective. This study determined the functional outcomes of patients who underwent interposition arthroplasty of the elbow with early post-operative active motion exercise protocol, foregoing external fixation.
Methodology. The study retrospectively reviewed charts of patients treated by a single surgeon for ankylosed elbows from 2017 to 2023 in a tertiary institution. All patients initiated early overhead active motion exercises as early as 24–48 hours post-surgery without any external fixation. Pre-operative and last follow-up functional outcomes were determined using the Mayo Elbow Performance and Fil-DASH scores.
Results. The study included six patients with a mean age of 44 (24–61). Mayo Elbow Performance improved by a mean of 23% and Fil-DASH scores improved by a mean of 92%. Patients’ average arc of motion was 65˚ at a mean follow-up of 20 months. All elbows were stable and painless throughout the arc of motion.
Conclusion. Interposition arthroplasty using tensor fascia lata graft combined with early overhead active motion is a viable surgical option for pain relief and improvement of motion in patients with elbow ankylosis who are candidates for either total elbow arthroplasty or arthrodesis.
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