The bone & joint journal · 2025
Mid-term clinical outcomes of the unlinked type K-NOW total elbow arthroplasty.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Matsuo Tomoki, Iwamoto Takuji, Kiyota Yasuhiro, Suzuki Taku, Matsumura Noboru, Sato Kazuki, Ikegami Hiroyasu
Аннотация
AIMS: This study aimed to evaluate the mid-term clinical outcomes, complications, and survival rates of the unlinked K-NOW (Teijin Nakashima Medical, Japan) total elbow arthroplasty (TEA), focusing on the use of cementless fixation.
METHODS: This retrospective study included 41 elbows in 37 patients who underwent primary TEA using unlinked K-NOW between April 2012 and March 2021, with a minimum follow-up of two years. Surgical approaches included the lateral paraolecranon (LPO) and triceps-off approaches. Clinical evaluations included range of motion (ROM) and Mayo Elbow Performance Score (MEPS). Complications were recorded, and Kaplan-Meier survival analysis was performed, with aseptic loosening and revision surgery as endpoints.
RESULTS: The mean patient age was 68.4 years (SD 11.6), and the mean follow-up period was 4.7 years (2.1 to 10.1). The LPO approach was used in 35 elbows (85.4%), and cementless fixation was applied to 41 humeral components (100%) and 35 ulnar components (85.4%). Among patients with ≥ five years of follow-up (n = 16), significant improvements were observed in ROM (extension, from -38° to -19°; flexion, from 107° to 130°; pronation, from 55° to 72°; supination, from 62° to 73°; p < 0.001), and MEPS (from 48 to 93 points; p < 0.001) at five years postoperatively. Complications occurred in six elbows (14.6%): three elbows (7.3%) with aseptic loosening and three elbows (7.3%) with periprosthetic fractures; no postoperative dislocation was observed. Revision surgeries were required in two elbows (4.9%). Kaplan-Meier survival rates were 92.7% (95% CI 84.7 to 100) at five years for loosening, and 97.1% (95% CI 91.4 to 100) at five years for revision. All aseptic loosening occurred within three months postoperatively.
CONCLUSION: The unlinked K-NOW with cementless fixation, mostly using the LPO approach, demonstrated favourable outcomes with improved ROM and MEPS, a low complication rate, and promising survival. In cases with severe osteoporosis or bone-implant instability, cemented fixation or a triceps-off approach may help reduce the risk of early complications.
METHODS: This retrospective study included 41 elbows in 37 patients who underwent primary TEA using unlinked K-NOW between April 2012 and March 2021, with a minimum follow-up of two years. Surgical approaches included the lateral paraolecranon (LPO) and triceps-off approaches. Clinical evaluations included range of motion (ROM) and Mayo Elbow Performance Score (MEPS). Complications were recorded, and Kaplan-Meier survival analysis was performed, with aseptic loosening and revision surgery as endpoints.
RESULTS: The mean patient age was 68.4 years (SD 11.6), and the mean follow-up period was 4.7 years (2.1 to 10.1). The LPO approach was used in 35 elbows (85.4%), and cementless fixation was applied to 41 humeral components (100%) and 35 ulnar components (85.4%). Among patients with ≥ five years of follow-up (n = 16), significant improvements were observed in ROM (extension, from -38° to -19°; flexion, from 107° to 130°; pronation, from 55° to 72°; supination, from 62° to 73°; p < 0.001), and MEPS (from 48 to 93 points; p < 0.001) at five years postoperatively. Complications occurred in six elbows (14.6%): three elbows (7.3%) with aseptic loosening and three elbows (7.3%) with periprosthetic fractures; no postoperative dislocation was observed. Revision surgeries were required in two elbows (4.9%). Kaplan-Meier survival rates were 92.7% (95% CI 84.7 to 100) at five years for loosening, and 97.1% (95% CI 91.4 to 100) at five years for revision. All aseptic loosening occurred within three months postoperatively.
CONCLUSION: The unlinked K-NOW with cementless fixation, mostly using the LPO approach, demonstrated favourable outcomes with improved ROM and MEPS, a low complication rate, and promising survival. In cases with severe osteoporosis or bone-implant instability, cemented fixation or a triceps-off approach may help reduce the risk of early complications.