Our Summary

The research paper is a study on a surgical technique called the Van Gorder approach, which is used for total elbow arthroplasty (TEA), a procedure to replace the elbow joint. The Van Gorder approach involves adjusting the triceps tendon without disturbing its attachment. This technique allows for clear visibility of the joint and is optimal for TEA.

The researchers looked at patients who had TEA using the Van Gorder approach between 2008 and 2016. They only included patients who had no previous elbow surgery and had at least six months of follow-ups after their TEA. They examined things like why the surgery was done, how much the elbow could move after surgery, how well the triceps worked, and if more surgery was needed. They also looked at patient-reported pain and quality of life.

Out of 53 patients who met their criteria, most were women around 62 years old. The most common reasons for surgery were inflammatory arthritis, osteoarthritis, and fractures. After surgery, the average range of elbow motion was quite good. Only one patient had an issue with their triceps, and 10 needed more surgery, usually for minor wound complications. Patient-reported pain significantly dropped starting at three months after surgery and remained low at 12 and 24 months after surgery.

In conclusion, the Van Gorder approach for TEA had similar results to other surgical techniques, and this study is the largest one looking at this specific approach. The researchers suggest that this approach is a good option for TEA.

FAQs

  1. What is the Van Gorder approach used in total elbow arthroplasty?
  2. What were the common reasons for patients needing total elbow arthroplasty?
  3. How does the Van Gorder approach compare to other surgical techniques for total elbow arthroplasty?

Doctor’s Tip

A helpful tip a doctor might tell a patient about elbow surgery using the Van Gorder approach is to follow post-operative instructions carefully to ensure proper healing and optimal outcomes. This may include attending physical therapy sessions, avoiding strenuous activities that could strain the elbow, and keeping the surgical site clean and protected. It is also important for patients to communicate any concerns or changes in symptoms to their healthcare provider during the recovery process.

Suitable For

Patients who are typically recommended elbow surgery using the Van Gorder approach for TEA are those with conditions such as inflammatory arthritis, osteoarthritis, and fractures that have not responded to other treatments. These patients may be experiencing severe pain, limited range of motion, and difficulty performing daily activities due to their elbow joint issues. Additionally, patients who have not had previous elbow surgery and have a good overall health status may be considered good candidates for this surgical technique.

It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if they are suitable candidates for elbow surgery using the Van Gorder approach. The findings from this study suggest that this surgical technique can provide favorable outcomes in terms of pain relief, improved range of motion, and overall quality of life for eligible patients.

Timeline

Before elbow surgery:

  • Patient experiences pain and limited range of motion in the elbow
  • Consultation with a surgeon to discuss the need for surgery and the different surgical techniques available
  • Preoperative testing and evaluations to ensure the patient is a good candidate for surgery
  • Consent for surgery and preparation for the procedure

After elbow surgery:

  • Patient undergoes the Van Gorder approach for total elbow arthroplasty
  • Postoperative care and monitoring in the hospital for a few days
  • Physical therapy and rehabilitation to regain strength and range of motion in the elbow
  • Follow-up appointments with the surgeon to monitor progress and address any concerns
  • Patient-reported pain and quality of life are assessed at regular intervals post-surgery
  • Continued improvement in elbow function and pain relief over time

Overall, the patient experiences relief from pain and improved function in the elbow following surgery, with the Van Gorder approach showing positive outcomes in terms of range of motion, triceps function, pain relief, and quality of life.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with the Van Gorder approach for total elbow arthroplasty?
  2. How long is the recovery process after surgery using the Van Gorder approach?
  3. Will I need physical therapy after surgery, and if so, for how long?
  4. How successful is the Van Gorder approach compared to other surgical techniques for total elbow arthroplasty?
  5. What type of anesthesia will be used during the surgery, and what are the potential side effects?
  6. What are the expected outcomes in terms of range of motion, pain relief, and improvement in quality of life after surgery?
  7. How long can I expect the elbow replacement to last before needing a revision surgery?
  8. Are there any specific precautions or limitations I should follow after surgery to ensure successful recovery?
  9. How experienced is the surgical team with performing TEA using the Van Gorder approach?
  10. Are there any alternative treatment options to consider before proceeding with surgery using the Van Gorder approach?

Reference

Authors: Kahan JB, Schneble CA, Simcock X, Evans PJ, Maschke SD, Seitz W, Donohue KW. Journal: J Shoulder Elbow Surg. 2022 Mar;31(3):495-500. doi: 10.1016/j.jse.2021.09.005. Epub 2021 Oct 13. PMID: 34653613