Prosthetic Replacement

14,000,000 Leading Edge Experts on the ideXlab platform

Scan Science and Technology

Contact Leading Edge Experts & Companies

Scan Science and Technology

Contact Leading Edge Experts & Companies

The Experts below are selected from a list of 12030 Experts worldwide ranked by ideXlab platform

Gloria B Chiu - One of the best experts on this subject based on the ideXlab platform.

  • Prosthetic Replacement of the ocular surface ecosystem scleral lens therapy for exposure keratopathy
    Eye & Contact Lens-science and Clinical Practice, 2017
    Co-Authors: Jasdeep S Chahal, Martin Heur, Gloria B Chiu
    Abstract:

    Objectives To investigate the utility of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral lenses in patients with exposure keratopathy, with outcomes based on changes in visual acuity, visual function, and corneal staining. Methods A retrospective interventional case series of patients evaluated and treated from September 2009 through June 2014 at a single multi-specialty institutional practice. Eighteen of 29 patients with exposure keratoconjunctivitis, lagophthalmos, ectropion, or lid retraction, referred to USC Eye Institute after failing conventional therapies completed PROSE scleral lens fitting and were included in the study. Visual function was assessed before and after PROSE fitting with the Ocular Surface Disease Index (OSDI) survey. Visual acuity (VA) and corneal staining changes were also evaluated before and after treatment. Results Visual acuity improved from 0.60±0.68 logMAR pre-PROSE to 0.25±0.34 logMAR (Z=-3.81, P=0.00014) post-PROSE, which corresponds to an improvement of about 20/80 to 20/35 on Snellen VA. Ocular Surface Disease Index scores improved from 56.54±29.75 pre-PROSE to 24.98±21.23 post-PROSE (Z=-2.98, P=0.0029), and corneal staining values decreased from 2.17±0.84 pre-PROSE to 0.64±0.70 post-PROSE (Z=-3.27, P=0.011). Conclusions The results suggest that PROSE scleral lens therapy is effective in patients with exposure keratopathy who had failed conventional therapies and can serve as an alternative to lid surgery.

  • use of Prosthetic Replacement of the ocular surface ecosystem scleral lenses in patients with ocular chronic graft versus host disease
    Biology of Blood and Marrow Transplantation, 2015
    Co-Authors: Christos Theophanous, John A Irvine, Pablo Parker, Gloria B Chiu
    Abstract:

    Abstract The purpose of this study was to evaluate the impact of Prosthetic Replacement of the ocular surface ecosystem (BostonSight PROSE, Boston Foundation for Sight, Needham, MA) treatment, utilizing customized scleral devices, on visual acuity, visual function, and ocular surface changes in patients with ocular chronic graft-versus-host disease (cGVHD). A retrospective analysis was performed on 79 eyes of 40 patients with cGVHD referred to the University of Southern California department of ophthalmology between November 2009 and July 2013 for PROSE treatment. This analysis included an assessment of ocular symptoms and visual function before and after treatment using the Ocular Surface Disease Index (OSDI) survey. Pre- and post-treatment visual acuity and clinical data were also compared. Twenty-eight male patients and 12 female patients were included in this study. The average age was 56.1 years (range, 27 to 74). Of the 79 eyes treated, 71 (90%) showed improved visual acuity with PROSE treatment. Fifty-seven eyes (72%) experienced a 2- or greater line visual acuity improvement and 14 eyes (18%) experienced a 1-line improvement. Average logarithm of the minimal angle of resolution improved from .49 ± .52 to .16 ± .44 (P

  • Prosthetic Replacement of the ocular surface ecosystem scleral lens therapy for patients with ocular symptoms of chronic stevens johnson syndrome
    American Journal of Ophthalmology, 2014
    Co-Authors: Martin Heur, Dianne Bach, Christos Theophanous, Gloria B Chiu
    Abstract:

    Purpose To evaluate the results of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral lens treatment on visual acuity and function in patients with ocular symptoms of chronic Stevens-Johnson syndrome (SJS). Design Retrospective interventional case series. Methods setting: Single multi-specialty institutional practice. study population: A chart review from July 2009 to July 2013 identified 19 patients with ocular symptoms from chronic SJS who were referred for PROSE fitting evaluation. Three patients deemed appropriate candidates were excluded because they were lost to follow-up during the fitting process. Only 1 eye was fitted in 4 patients because anatomic changes prohibited PROSE fitting in the fellow eye. Another patient chose to have PROSE fitting only in 1 eye. A total of 27 eyes of 16 patients who completed PROSE fitting were included in this study. intervention: PROSE scleral lens fitting. outcome measures: Visual acuity and visual function were assessed before and after PROSE fitting using Snellen acuity and Ocular Surface Disease Index (OSDI) survey. The OSDI survey is a validated questionnaire that assesses ocular surface disease in the context of vision-related function, ocular symptoms, and environmental triggers. Results Visual acuity improved from 0.43 ± 0.35 logMAR pre-PROSE to 0.14 ± 0.22 logMAR post-PROSE ( P  = .0007) in SJS patients. OSDI scores improved from 70.4 ± 19.0 pre-PROSE to 37.4 ± 23.2 post-PROSE ( P  = .0002) in the same cohort. Conclusion The results of this study show that PROSE treatment is a viable option for improving visual acuity and function in SJS patients who failed conventional treatment.

  • functional and visual improvement with Prosthetic Replacement of the ocular surface ecosystem scleral lenses for irregular corneas
    Cornea, 2013
    Co-Authors: Jennifer C Lee, Dianne Bach, Gloria B Chiu, Simon R Bababeygy, John A Irvine, Martin Heur
    Abstract:

    Purpose:To evaluate the Doheny Eye Institute Experience with Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral lenses for the management of irregular corneas with outcomes based on visual acuity (VA) and visual function.Methods:A retrospective chart review of 58 subjects (90 eye

Deborah S. Jacobs - One of the best experts on this subject based on the ideXlab platform.

  • Improvement of chronic corneal opacity in ocular surface disease with Prosthetic Replacement of the ocular surface ecosystem (PROSE) treatment
    Elsevier, 2018
    Co-Authors: Anna Cressey, Deborah S. Jacobs, Crystal Remington, Karen G. Carrasquillo
    Abstract:

    Purpose: To demonstrate clearing of chronic corneal opacities and improvement of visual acuity with the use of BostonSight Prosthetic Replacement of the ocular surface ecosystem (PROSE) treatment in ocular surface disease. Observations: We undertook retrospective analysis of the medical records of a series of patients who underwent PROSE treatment from August 2006 to December 2014. Patients were referred for ocular surface disease of various etiologies. Primary inclusion criterion was corneal opacity that improved with PROSE treatment. Patients were excluded if topical steroids or adjuvant therapy used once PROSE treatment was initiated. Underlying disease, prior treatment, clinical presentation, and clinical course were extracted from the medical record. Four patients are included in this series. There were three females and one male; median age at time of treatment initiation was 30 years (range = 0.5–58 years). Median duration of PROSE treatment at time of retrospective analysis was 3.5 years (range = 1–8 years). Two cases had corneal opacification in the context of neurotrophic keratopathy: a unilateral case due to presumed herpes simplex keratitis and a bilateral case due to congenital corneal anesthesia associated with familial dysautonomia. One case had corneal opacity from exposure related to seventh nerve palsy, and one had corneal opacification associated with recurrent surface breakdown, neurotrophic keratopathy, and limbal stem deficiency of uncertain etiology. After consistent wear of Prosthetic devices used in PROSE treatment for support of the ocular surface, visual acuity improved and clearing of the opacities was observed, without use of topical steroids or adjuvant therapy. Conclusions and importance: These cases demonstrate clearing of chronic corneal opacity with PROSE treatment for ocular surface disease. This clearing can occur with no adjuvant therapy, suggesting that restoration of ocular surface function and integrity allows for corneal remodeling. Keywords: PROSE treatment, Ocular surface disease, Opacity, Corneal scar, Dry eye syndrome, Scleral lenses, Scleral Prosthetic device

  • Prosthetic Replacement of the ocular surface ecosystem treatment of ocular surface disease after skull base tumor resection
    World Neurosurgery, 2017
    Co-Authors: Carolyn E Kloek, Karen W Jengmiller, Deborah S. Jacobs, Ian F Dunn
    Abstract:

    Background Prosthetic Replacement of the ocular surface ecosystem (PROSE) treatment is an effective, nonsurgical therapeutic option for patients with ocular surface disease related to cranial nerve deficits secondary to skull base tumor resection. Methods This case series describes the impact of PROSE treatment in patients with symptomatic exposure keratopathy or neurotrophic keratitis after skull base tumor surgery. Results All patients improved symptomatically and functionally with PROSE treatment, and have had sustained improvement for as long as 3 years. Conclusions In postneurosurgical cases in which neurologic function may recover, PROSE treatment offers a safe, nonsurgical treatment option to support the ocular surface during the period of observation awaiting neurologic recovery.

  • Prosthetic Replacement of the ocular surface ecosystem impact at 5 years
    British Journal of Ophthalmology, 2016
    Co-Authors: Joshua S Agranat, Nicole Kitos, Deborah S. Jacobs
    Abstract:

    Background/aims To determine the impact of Prosthetic Replacement of the ocular surface ecosystem (PROSE) treatment at 5 years. Methods Retrospective review of clinical, manufacturing and quality databases at the Boston Foundation for Sight. Results 121 patients who completed treatment and had 5-year follow-up data were identified from a cohort of patients (n=199) seen in consultation for PROSE treatment from January 2008 to June 2008. Mean age was 52 years, M:F=56:65. The primary indication for treatment was ocular surface disease (OSD) in 64 patients and distorted corneal surface in 57 patients. At 5 years, continued device wear was confirmed in 89/121 (73.6%) patients. Discontinuation of wear was confirmed in 32/121 (26.4%). There was an increased likelihood of continued device wear at 5 years in patients with distorted cornea (84%) compared with those with OSD (64%), (p=0.0121, χ2). National Eye Institute Visual Function Questionnaire (NEI VFQ-25) composite score increased for patients wearing PROSE devices at 6 months (Δ=+23 points, mean=82, p<0.001, two-tailed t test) with no significant decline among those still wearing a device at 5 years (Δ=−4 points, mean=78, p=0.22, two-tailed t test). At 5 years, those wearing (mean=78) had a higher NEI VFQ-25 than those not wearing (mean=70, p=0.029, two-tailed t test). Conclusions PROSE treatment offers continued benefit, as defined by improved visual function and continued device wear at 5 years, in patients with complex corneal disease. Patients with distorted cornea have a higher rate of continued wear at 5 years than patients with OSD, although this is not true among all subgroups within OSD.

  • Prosthetic Replacement of the ocular surface ecosystem as treatment for ocular surface disease in patients with a history of stevens johnson syndrome toxic epidermal necrolysis
    Ophthalmology, 2015
    Co-Authors: Thanos D Papakostas, Deborah S. Jacobs, James Chodosh
    Abstract:

    Purpose To report the visual outcomes of Prosthetic Replacement of the ocular surface ecosystem (PROSE) treatment in patients with ocular surface disease related to Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Design Retrospective cohort study. Subjects We included 86 patients (167 eyes) with history of SJS/TEN who underwent PROSE treatment from January 1, 2006, to January 1, 2011. Methods Etiology, previous interventions, change in visual acuity, change in visual function, and duration of follow-up are reported. Paired t test and Friedman test with Dunn's post hoc test for multiple comparisons were used for statistical analysis. Main Outcome Measures Visual acuity at last follow-up and visual function based on the National Eye Institute 25-item Visual Functioning Questionnaire (NEI VFQ-25) at 6 months. Results We treated 35 males and 51 females with a history of SJS/TENS; median age was 36 years. The most common reported etiologies for SJS/TENS were antibiotics (n = 25), ibuprofen (n = 15), and lamotrigine (n = 11). The median visual acuity at the initial visit was 20/60 (range, 20/400–20/25; 0.48 logarithm of the minimum angle of resolution [logMAR]), and the visual acuity at completion of customization was 20/25 (range, 20/200–20/20; 0.096 logMAR; P P P Conclusions In a large cohort of patients with chronic ocular surface disease related to SJS/TEN, PROSE treatment offers sustained and significant large improvement in visual function and acuity.

Otto Sneppen - One of the best experts on this subject based on the ideXlab platform.

  • elbow joint laxity after experimental radial head excision and lateral collateral ligament rupture efficacy of Prosthetic Replacement and ligament repair
    Journal of Shoulder and Elbow Surgery, 2005
    Co-Authors: Steen Lund Jensen, Bo S Olsen, Stein Tyrdal, Jens Ole Sojbjerg, Otto Sneppen
    Abstract:

    The objectives of this experimental study were to investigate the effect of radial head excision and lateral collateral ligament (LCL) division on elbow joint laxity and to determine the efficacy of radial head Prosthetic Replacement and LCL repair. Valgus, varus, internal rotation, and external rotation of the ulna were measured during passive flexion-extension and application of a 0.75-Nm torque in 6 intact cadaveric elbows and after (1) either excision of the radial head or division of the LCL, (2) removal of both constraints, (3) isolated radial head Prosthetic Replacement, (4) isolated LCL repair, and (5) radial head Replacement combined with LCL repair. Isolated radial head excision increased varus (mean, 4.8°) and external rotatory laxity (mean, 7.1°), as did isolated LCL division (mean, 14.1° for varus; mean, 14.7° for external rotation). After removal of both constraints, varus and external rotatory laxities were increased by 19.0° and 20.1°, respectively, compared with the intact specimens. Isolated radial head Replacement reduced mean varus laxity to 14.6° and mean external rotatory laxity to 14.8°. Isolated LCL repair normalized varus laxity but resulted in a 2.9° increase in external rotatory laxity. The combined procedures restored laxity completely. The radial head is a constraint to varus and external rotation in the elbow joint, functioning by maintaining tension in the LCL. Still, removal of both constraints induces severe laxity, and in this case, Prosthetic Replacement may substitute for the constraining capacity of the native radial head. The combination of LCL repair and radial head Replacement restores laxity completely, but an isolated LCL repair performs almost as well, probably by compensating for the ligamentous tension lost from radial head excision.

  • elbow joint laxity after experimental radial head excision and lateral collateral ligament rupture efficacy of Prosthetic Replacement and ligament repair
    Journal of Shoulder and Elbow Surgery, 2005
    Co-Authors: Steen Lund Jensen, Bo S Olsen, Stein Tyrdal, Jens Ole Sojbjerg, Otto Sneppen
    Abstract:

    The objectives of this experimental study were to investigate the effect of radial head excision and lateral collateral ligament (LCL) division on elbow joint laxity and to determine the efficacy of radial head Prosthetic Replacement and LCL repair. Valgus, varus, internal rotation, and external rotation of the ulna were measured during passive flexion-extension and application of a 0.75-Nm torque in 6 intact cadaveric elbows and after (1) either excision of the radial head or division of the LCL, (2) removal of both constraints, (3) isolated radial head Prosthetic Replacement, (4) isolated LCL repair, and (5) radial head Replacement combined with LCL repair. Isolated radial head excision increased varus (mean, 4.8 degrees) and external rotatory laxity (mean, 7.1 degrees), as did isolated LCL division (mean, 14.1 degrees for varus; mean, 14.7 degrees for external rotation). After removal of both constraints, varus and external rotatory laxities were increased by 19.0 degrees and 20.1 degrees, respectively, compared with the intact specimens. Isolated radial head Replacement reduced mean varus laxity to 14.6 degrees and mean external rotatory laxity to 14.8 degrees. Isolated LCL repair normalized varus laxity but resulted in a 2.9 degrees increase in external rotatory laxity. The combined procedures restored laxity completely. The radial head is a constraint to varus and external rotation in the elbow joint, functioning by maintaining tension in the LCL. Still, removal of both constraints induces severe laxity, and in this case, Prosthetic Replacement may substitute for the constraining capacity of the native radial head. The combination of LCL repair and radial head Replacement restores laxity completely, but an isolated LCL repair performs almost as well, probably by compensating for the ligamentous tension lost from radial head excision.

  • laxity of the elbow after experimental excision of the radial head and division of the medial collateral ligament efficacy of ligament repair and radial head Prosthetic Replacement a cadaver study
    Journal of Bone and Joint Surgery-british Volume, 2003
    Co-Authors: Steen Lund Jensen, Bo S Olsen, Jens Ole Sojbjerg, Soren R Deutch, Otto Sneppen
    Abstract:

    We studied the stabilising effect of Prosthetic Replacement of the radial head and repair of the medial collateral ligament (MCL) after excision of the radial head and section of the MCL in five cadaver elbows. Division of the MCL increased valgus angulation (mean 3.9 +/- 1.5 degrees) and internal rotatory laxity (mean 5.3 +/- 2.0 degrees). Subsequent excision of the radial head allowed additional valgus (mean 11.1 +/- 7.3 degrees) and internal rotatory laxity (mean 5.7 +/- 3.9 degrees). Isolated Replacement of the radial head reduced valgus laxity to the level before excision of the head, while internal rotatory laxity was still greater (2.8 +/- 2.1 degrees). Isolated repair of the MCL corrected internal rotatory laxity, but a slight increase in valgus laxity remained (mean 0.7 +/- 0.6 degrees). Combined Replacement of the head and repair of the MCL restored stability completely. We conclude that the radial head is a constraint secondary to the MCL for both valgus displacement and internal rotation. Isolated repair of the ligament is superior to isolated Prosthetic Replacement and may be sufficient to restore valgus and internal rotatory stability after excision of the radial head in MCL-deficient elbows.

Martin Heur - One of the best experts on this subject based on the ideXlab platform.

  • Prosthetic Replacement of the ocular surface ecosystem scleral lens therapy for exposure keratopathy
    Eye & Contact Lens-science and Clinical Practice, 2017
    Co-Authors: Jasdeep S Chahal, Martin Heur, Gloria B Chiu
    Abstract:

    Objectives To investigate the utility of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral lenses in patients with exposure keratopathy, with outcomes based on changes in visual acuity, visual function, and corneal staining. Methods A retrospective interventional case series of patients evaluated and treated from September 2009 through June 2014 at a single multi-specialty institutional practice. Eighteen of 29 patients with exposure keratoconjunctivitis, lagophthalmos, ectropion, or lid retraction, referred to USC Eye Institute after failing conventional therapies completed PROSE scleral lens fitting and were included in the study. Visual function was assessed before and after PROSE fitting with the Ocular Surface Disease Index (OSDI) survey. Visual acuity (VA) and corneal staining changes were also evaluated before and after treatment. Results Visual acuity improved from 0.60±0.68 logMAR pre-PROSE to 0.25±0.34 logMAR (Z=-3.81, P=0.00014) post-PROSE, which corresponds to an improvement of about 20/80 to 20/35 on Snellen VA. Ocular Surface Disease Index scores improved from 56.54±29.75 pre-PROSE to 24.98±21.23 post-PROSE (Z=-2.98, P=0.0029), and corneal staining values decreased from 2.17±0.84 pre-PROSE to 0.64±0.70 post-PROSE (Z=-3.27, P=0.011). Conclusions The results suggest that PROSE scleral lens therapy is effective in patients with exposure keratopathy who had failed conventional therapies and can serve as an alternative to lid surgery.

  • Prosthetic Replacement of the ocular surface ecosystem scleral lens therapy for patients with ocular symptoms of chronic stevens johnson syndrome
    American Journal of Ophthalmology, 2014
    Co-Authors: Martin Heur, Dianne Bach, Christos Theophanous, Gloria B Chiu
    Abstract:

    Purpose To evaluate the results of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral lens treatment on visual acuity and function in patients with ocular symptoms of chronic Stevens-Johnson syndrome (SJS). Design Retrospective interventional case series. Methods setting: Single multi-specialty institutional practice. study population: A chart review from July 2009 to July 2013 identified 19 patients with ocular symptoms from chronic SJS who were referred for PROSE fitting evaluation. Three patients deemed appropriate candidates were excluded because they were lost to follow-up during the fitting process. Only 1 eye was fitted in 4 patients because anatomic changes prohibited PROSE fitting in the fellow eye. Another patient chose to have PROSE fitting only in 1 eye. A total of 27 eyes of 16 patients who completed PROSE fitting were included in this study. intervention: PROSE scleral lens fitting. outcome measures: Visual acuity and visual function were assessed before and after PROSE fitting using Snellen acuity and Ocular Surface Disease Index (OSDI) survey. The OSDI survey is a validated questionnaire that assesses ocular surface disease in the context of vision-related function, ocular symptoms, and environmental triggers. Results Visual acuity improved from 0.43 ± 0.35 logMAR pre-PROSE to 0.14 ± 0.22 logMAR post-PROSE ( P  = .0007) in SJS patients. OSDI scores improved from 70.4 ± 19.0 pre-PROSE to 37.4 ± 23.2 post-PROSE ( P  = .0002) in the same cohort. Conclusion The results of this study show that PROSE treatment is a viable option for improving visual acuity and function in SJS patients who failed conventional treatment.

  • functional and visual improvement with Prosthetic Replacement of the ocular surface ecosystem scleral lenses for irregular corneas
    Cornea, 2013
    Co-Authors: Jennifer C Lee, Dianne Bach, Gloria B Chiu, Simon R Bababeygy, John A Irvine, Martin Heur
    Abstract:

    Purpose:To evaluate the Doheny Eye Institute Experience with Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) scleral lenses for the management of irregular corneas with outcomes based on visual acuity (VA) and visual function.Methods:A retrospective chart review of 58 subjects (90 eye

Steen Lund Jensen - One of the best experts on this subject based on the ideXlab platform.

  • elbow joint laxity after experimental radial head excision and lateral collateral ligament rupture efficacy of Prosthetic Replacement and ligament repair
    Journal of Shoulder and Elbow Surgery, 2005
    Co-Authors: Steen Lund Jensen, Bo S Olsen, Stein Tyrdal, Jens Ole Sojbjerg, Otto Sneppen
    Abstract:

    The objectives of this experimental study were to investigate the effect of radial head excision and lateral collateral ligament (LCL) division on elbow joint laxity and to determine the efficacy of radial head Prosthetic Replacement and LCL repair. Valgus, varus, internal rotation, and external rotation of the ulna were measured during passive flexion-extension and application of a 0.75-Nm torque in 6 intact cadaveric elbows and after (1) either excision of the radial head or division of the LCL, (2) removal of both constraints, (3) isolated radial head Prosthetic Replacement, (4) isolated LCL repair, and (5) radial head Replacement combined with LCL repair. Isolated radial head excision increased varus (mean, 4.8°) and external rotatory laxity (mean, 7.1°), as did isolated LCL division (mean, 14.1° for varus; mean, 14.7° for external rotation). After removal of both constraints, varus and external rotatory laxities were increased by 19.0° and 20.1°, respectively, compared with the intact specimens. Isolated radial head Replacement reduced mean varus laxity to 14.6° and mean external rotatory laxity to 14.8°. Isolated LCL repair normalized varus laxity but resulted in a 2.9° increase in external rotatory laxity. The combined procedures restored laxity completely. The radial head is a constraint to varus and external rotation in the elbow joint, functioning by maintaining tension in the LCL. Still, removal of both constraints induces severe laxity, and in this case, Prosthetic Replacement may substitute for the constraining capacity of the native radial head. The combination of LCL repair and radial head Replacement restores laxity completely, but an isolated LCL repair performs almost as well, probably by compensating for the ligamentous tension lost from radial head excision.

  • elbow joint laxity after experimental radial head excision and lateral collateral ligament rupture efficacy of Prosthetic Replacement and ligament repair
    Journal of Shoulder and Elbow Surgery, 2005
    Co-Authors: Steen Lund Jensen, Bo S Olsen, Stein Tyrdal, Jens Ole Sojbjerg, Otto Sneppen
    Abstract:

    The objectives of this experimental study were to investigate the effect of radial head excision and lateral collateral ligament (LCL) division on elbow joint laxity and to determine the efficacy of radial head Prosthetic Replacement and LCL repair. Valgus, varus, internal rotation, and external rotation of the ulna were measured during passive flexion-extension and application of a 0.75-Nm torque in 6 intact cadaveric elbows and after (1) either excision of the radial head or division of the LCL, (2) removal of both constraints, (3) isolated radial head Prosthetic Replacement, (4) isolated LCL repair, and (5) radial head Replacement combined with LCL repair. Isolated radial head excision increased varus (mean, 4.8 degrees) and external rotatory laxity (mean, 7.1 degrees), as did isolated LCL division (mean, 14.1 degrees for varus; mean, 14.7 degrees for external rotation). After removal of both constraints, varus and external rotatory laxities were increased by 19.0 degrees and 20.1 degrees, respectively, compared with the intact specimens. Isolated radial head Replacement reduced mean varus laxity to 14.6 degrees and mean external rotatory laxity to 14.8 degrees. Isolated LCL repair normalized varus laxity but resulted in a 2.9 degrees increase in external rotatory laxity. The combined procedures restored laxity completely. The radial head is a constraint to varus and external rotation in the elbow joint, functioning by maintaining tension in the LCL. Still, removal of both constraints induces severe laxity, and in this case, Prosthetic Replacement may substitute for the constraining capacity of the native radial head. The combination of LCL repair and radial head Replacement restores laxity completely, but an isolated LCL repair performs almost as well, probably by compensating for the ligamentous tension lost from radial head excision.

  • laxity of the elbow after experimental excision of the radial head and division of the medial collateral ligament efficacy of ligament repair and radial head Prosthetic Replacement a cadaver study
    Journal of Bone and Joint Surgery-british Volume, 2003
    Co-Authors: Steen Lund Jensen, Bo S Olsen, Jens Ole Sojbjerg, Soren R Deutch, Otto Sneppen
    Abstract:

    We studied the stabilising effect of Prosthetic Replacement of the radial head and repair of the medial collateral ligament (MCL) after excision of the radial head and section of the MCL in five cadaver elbows. Division of the MCL increased valgus angulation (mean 3.9 +/- 1.5 degrees) and internal rotatory laxity (mean 5.3 +/- 2.0 degrees). Subsequent excision of the radial head allowed additional valgus (mean 11.1 +/- 7.3 degrees) and internal rotatory laxity (mean 5.7 +/- 3.9 degrees). Isolated Replacement of the radial head reduced valgus laxity to the level before excision of the head, while internal rotatory laxity was still greater (2.8 +/- 2.1 degrees). Isolated repair of the MCL corrected internal rotatory laxity, but a slight increase in valgus laxity remained (mean 0.7 +/- 0.6 degrees). Combined Replacement of the head and repair of the MCL restored stability completely. We conclude that the radial head is a constraint secondary to the MCL for both valgus displacement and internal rotation. Isolated repair of the ligament is superior to isolated Prosthetic Replacement and may be sufficient to restore valgus and internal rotatory stability after excision of the radial head in MCL-deficient elbows.

Related terms

Prosthetic Replacement - 15 days free trial to Access Experts & Abstracts