{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T10:14:41Z","timestamp":1783332881283,"version":"3.54.6"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to evaluate periprosthetic fracture management following unlinked total elbow arthroplasty (TEA) based on a retrospective case series analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The medical records of 13 patients with periprosthetic fractures who underwent unlinked Kudo TEA at our institution between 2013 and 2022 were retrospectively reviewed. Postoperative assessment included elbow range of motion, radiographic evaluation, and the Mayo elbow performance score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 13 patients, 11 were managed surgically, and two received conservative treatment. Seven patients with component loosening and insufficient bone stock underwent revision to a linked TEA. Three patients with isolated ulnar loosening but preserved bone stock underwent revision with a long-stemmed unlinked ulnar component. One patient was treated with internal fixation. At the latest follow-up, the mean total arc of elbow motion was 91\u00b0. The mean Mayo elbow performance score was 85. All cases of aseptic loosening were treated without using strut bone allografts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Unlinked Kudo TEA is an effective option for primary TEA, considering the possibility of future periprosthetic fractures, as revision procedures are more straightforward than those for linked TEA. When loosening is observed, early intervention is advised to reduce the risk of periprosthetic fractures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/mr\/roag009","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:45:34Z","timestamp":1770813934000},"page":"657-663","source":"Crossref","is-referenced-by-count":0,"title":["Treatment outcomes of periprosthetic fracture following unlinked total elbow arthroplasty: A case series study"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4028-2150","authenticated-orcid":false,"given":"Yuhei","family":"Horiguchi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Sapporo Medical University , Sapporo ,","place":["Japan"]},{"name":"Department of Orthopaedic Surgery, NHO Sagamihara National Hospital , Sagamihara ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, NHO Sagamihara National Hospital , Sagamihara ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuyasu","family":"Iwasawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, NHO Sagamihara National Hospital , Sagamihara ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Yasui","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Teikyo University Mizonokuchi Hospital , Kawasaki ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Teramoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Sapporo Medical University , Sapporo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakae","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Tokyo Hospital , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"2026070605221737900_ref1","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1302\/0301-620X.88B7.17356","article-title":"Kudo type-5 total elbow arthroplasty in mutilating rheumatoid arthritis: a 5- to 11-year follow-up","volume":"88","author":"Mori","year":"2006","journal-title":"J Bone Joint Surg Br"},{"key":"2026070605221737900_ref2","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1302\/0301-620X.54B1.88","article-title":"Total replacement arthroplasty of the elbow for rheumatoid arthritis","volume":"54","author":"Dee","year":"1972","journal-title":"J Bone Joint Surg Br"},{"key":"2026070605221737900_ref3","first-page":"653","article-title":"Total replacement arthroplasty of the elbow joint for rheumatoid arthritis: two cases","volume":"63","author":"Dee","year":"1970","journal-title":"Proc R Soc Med"},{"key":"2026070605221737900_ref4","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.jse.2018.08.024","article-title":"Outcomes after revision total elbow arthroplasty: a systematic review","volume":"28","author":"Geurts","year":"2019","journal-title":"J Shoulder Elb Surg"},{"key":"2026070605221737900_ref5","doi-asserted-by":"crossref","first-page":"S37","DOI":"10.1016\/j.injury.2015.08.011","article-title":"Total elbow joint replacement for fractures in the elderly--functional and radiological outcomes","volume":"46","author":"Pooley","year":"2015","journal-title":"Injury"},{"key":"2026070605221737900_ref6","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1016\/j.jse.2017.04.003","article-title":"Total elbow arthroplasty for primary osteoarthritis","volume":"26","author":"Schoch","year":"2017","journal-title":"J Shoulder Elb Surg"},{"key":"2026070605221737900_ref7","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.2106\/00004623-199809000-00012","article-title":"The Coonrad-Morrey total elbow arthroplasty in patients who have rheumatoid arthritis. A ten to fifteen-year follow-up study","volume":"80","author":"Gill","year":"1998","journal-title":"J Bone Joint Surg Am"},{"key":"2026070605221737900_ref8","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1197\/j.jht.2006.02.010","article-title":"Total elbow arthroplasty","volume":"19","author":"Szekeres","year":"2006","journal-title":"J Hand Ther"},{"key":"2026070605221737900_ref9","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.1016\/j.jse.2020.11.014","article-title":"Long term outcomes of total elbow arthroplasty: a systematic review of studies at 10-year follow-up","volume":"30","author":"Davey","year":"2021","journal-title":"J Shoulder Elb Surg"},{"key":"2026070605221737900_ref10","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.jse.2010.08.026","article-title":"Complications of total elbow replacement: a systematic review","volume":"20","author":"Voloshin","year":"2011","journal-title":"J Shoulder Elb Surg"},{"key":"2026070605221737900_ref11","doi-asserted-by":"crossref","first-page":"355","DOI":"10.2106\/00004623-199072030-00006","article-title":"Total elbow arthroplasty with a non-constrained surface-replacement prosthesis in patients who have rheumatoid arthritis: a long-term follow-up study","volume":"72","author":"Kudo","year":"1990","journal-title":"J Bone Joint Surg Am"},{"key":"2026070605221737900_ref12","doi-asserted-by":"publisher","first-page":"19","DOI":"10.2302\/kjm.2017-0007-IR","article-title":"The history and future of unlinked total elbow arthroplasty","volume":"67","author":"Iwamoto","year":"2018","journal-title":"Keio J Med"},{"key":"2026070605221737900_ref13","doi-asserted-by":"crossref","first-page":"452","DOI":"10.3109\/s10165-010-0309-3","article-title":"Effect of total knee arthroplasty on disease activity in patients with established rheumatoid arthritis: 3-year follow-up results of combined medical therapy and surgical intervention","volume":"20","author":"Yano","year":"2010","journal-title":"Mod Rheumatol"},{"key":"2026070605221737900_ref14","doi-asserted-by":"crossref","first-page":"862","DOI":"10.3899\/jrheum.131018","article-title":"Recent trends in orthopedic surgery aiming to improve quality of life for those with rheumatoid arthritis: data from a large observational cohort","volume":"41","author":"Momohara","year":"2014","journal-title":"J Rheumatol"},{"key":"2026070605221737900_ref15","doi-asserted-by":"crossref","first-page":"369","DOI":"10.4055\/cios.2019.11.4.369","article-title":"Total elbow arthroplasty: clinical outcomes, complications, and revision surgery","volume":"11","author":"Kwak","year":"2019","journal-title":"Clin Orthop Surg"},{"key":"2026070605221737900_ref16","doi-asserted-by":"crossref","first-page":"189","DOI":"10.11138\/ccmbm\/2017.14.1.189","article-title":"Periprosthetic fractures: epidemiology and current treatment","volume":"14","author":"Capone","year":"2017","journal-title":"Clin Cases Miner Bone Metab"},{"key":"2026070605221737900_ref17","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/S0030-5898(05)70086-9","article-title":"Periprosthetic fractures about the elbow","volume":"30","author":"O\u2019Driscoll","year":"1999","journal-title":"Orthop Clin North Am"},{"key":"2026070605221737900_ref18","doi-asserted-by":"publisher","first-page":"77","DOI":"10.11138\/ccmbm\/2017.14.1.189","article-title":"The Souter-Strathclyde elbow arthroplasty. A clinical and radiological study of 525 consecutive cases","volume":"84","author":"Ik\u00e4valko","year":"2002","journal-title":"J Bone Joint Surg Br"},{"key":"2026070605221737900_ref19","doi-asserted-by":"publisher","first-page":"S66","DOI":"10.1097\/BOT.0b013e31821b8c28","article-title":"Periprosthetic fractures: epidemiology and future projections","volume":"25","author":"Della Rocca","year":"2011","journal-title":"J Orthop Trauma"},{"key":"2026070605221737900_ref20","doi-asserted-by":"publisher","first-page":"e166","DOI":"10.5435\/JAAOS-D-15-00479","article-title":"Revision total elbow arthroplasty","volume":"25","author":"Ramirez","year":"2017","journal-title":"J Am Acad Orthop Surg"},{"key":"2026070605221737900_ref21","doi-asserted-by":"publisher","first-page":"1399","DOI":"10.2106\/JBJS.J.00102","article-title":"The surgical treatment of periprosthetic elbow fractures around the ulnar stem following semiconstrained total elbow arthroplasty","volume":"93","author":"Foruria","year":"2011","journal-title":"J Bone Joint Surg Am"},{"key":"2026070605221737900_ref22","doi-asserted-by":"publisher","first-page":"74","DOI":"10.2106\/JBJS.J.00102","volume-title":"The elbow and its disorders","author":"Morrey","year":"2000","edition":"3rd edn"},{"key":"2026070605221737900_ref23","doi-asserted-by":"crossref","first-page":"724","DOI":"10.2106\/00004623-200404000-00009","article-title":"Allograft-prosthesis composite for revision of catastrophic failure of total elbow arthroplasty","volume":"86","author":"Mansat","year":"2004","journal-title":"J Bone Joint Surg Am"},{"key":"2026070605221737900_ref24","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/S0035-1040(04)70127-0","article-title":"Total elbow joint allograft for long term posttraumatic osteoarticular loss. Follow-up results at twelve years (in French)","volume":"90","author":"Allieu","year":"2004","journal-title":"Rev Chir Orthop Reparatrice Appar Mot"},{"key":"2026070605221737900_ref25","doi-asserted-by":"publisher","first-page":"e4","DOI":"10.2106\/JBJS.RVW.16.00089","article-title":"Total elbow arthroplasty: a systematic review","volume":"5","author":"Welsink","year":"2017","journal-title":"JBJS Rev"},{"key":"2026070605221737900_ref26","doi-asserted-by":"publisher","first-page":"1380","DOI":"10.1016\/j.jse.2018.05.002","article-title":"Macroscopic investigation of failed Kudo type 5 total elbow arthroplasty","volume":"27","author":"Kodama","year":"2018","journal-title":"J Shoulder Elb Surg"},{"key":"2026070605221737900_ref27","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.2106\/00004623-200209000-00019","article-title":"Periprosthetic humeral fractures after total elbow arthroplasty: treatment with implant revision and strut allograft augmentation","volume":"84","author":"Sanchez-Sotelo","year":"2002","journal-title":"J Bone Joint Surg Am"},{"key":"2026070605221737900_ref28","doi-asserted-by":"crossref","first-page":"618","DOI":"10.2106\/JBJS.20.00889","article-title":"Revision total elbow arthroplasty with the semiconstrained coonrad\/morrey prosthesis: follow-up to 21 years","volume":"103","author":"Barret","year":"2021","journal-title":"J Bone Joint Surg Am"},{"key":"2026070605221737900_ref29","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/j.jse.2018.05.002","article-title":"Comparison of two types of ulnar component in type-5 Kudo total elbow arthroplasty in patients with rheumatoid arthritis: a long-term follow-up","volume":"88","author":"Tanaka","year":"2006","journal-title":"J Bone Joint Surg Br"}],"container-title":["Modern Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mr\/advance-article-pdf\/doi\/10.1093\/mr\/roag009\/66850836\/roag009.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mr\/article-pdf\/36\/4\/657\/66850836\/roag009.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mr\/article-pdf\/36\/4\/657\/66850836\/roag009.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T09:23:10Z","timestamp":1783329790000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mr\/article\/36\/4\/657\/8472598"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,11]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,2,11]]},"published-print":{"date-parts":[[2026,6,30]]}},"URL":"https:\/\/doi.org\/10.1093\/mr\/roag009","relation":{},"ISSN":["1439-7595","1439-7609"],"issn-type":[{"value":"1439-7595","type":"print"},{"value":"1439-7609","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,2,11]]}}}