{"id":5457,"date":"2025-07-01T09:00:00","date_gmt":"2025-07-01T09:00:00","guid":{"rendered":"https:\/\/www.orthogate.org\/press\/uncategorized\/total-elbow-arthroplasty-review\/"},"modified":"2025-07-01T13:26:04","modified_gmt":"2025-07-01T13:26:04","slug":"total-elbow-arthroplasty-review","status":"publish","type":"post","link":"https:\/\/www.orthogate.org\/press\/deep-research\/hand-upper-extremity-restoring-function-and-dexterity\/total-elbow-arthroplasty-review\/","title":{"rendered":"Total Elbow Arthroplasty Review"},"content":{"rendered":"

Total Elbow Arthroplasty: A Comprehensive Review<\/b> <\/span><\/span><\/h1>\n\n

<\/p>\n

Total elbow arthroplasty (TEA) is a surgical procedure in which a surgeon replaces damaged portions of the elbow joint with an artificial joint. This procedure is a treatment option for patients with end-stage arthritis of the elbow joint<\/span>1<\/sup><\/span>. When the cartilage in the joint is worn out, it can lead to pain and stiffness in the elbow, which can severely limit function<\/span>1<\/sup><\/span>. TEA is also indicated for acute distal humerus fractures<\/span>2<\/sup><\/span>. This comprehensive review will discuss the indications for TEA, different surgical approaches and implant designs, and analyze the long-term outcomes and potential complications.<\/span><\/p>\n

Indications for Total Elbow Arthroplasty<\/b> <\/span><\/span><\/h2>\n\n

Conditions that can damage the elbow joint include many types of arthritis, bone fractures, and bone tumors<\/span>3<\/sup><\/span>. The most common indication for TEA is inflammatory arthritis, followed by acute fracture and osteoarthritis<\/span>4<\/sup><\/span>.<\/span><\/p>\n

Rheumatoid Arthritis<\/b> <\/span><\/span><\/h3>\n\n

Rheumatoid arthritis (RA) is a chronic inflammatory disease that can affect many joints in the body, including the elbow<\/span>5<\/sup><\/span>. In the past, RA was the most common indication for TEA<\/span>6<\/sup><\/span>. However, with the advancement of antirheumatic drugs, the number of TEAs performed for inflammatory arthritis has decreased<\/span>7<\/sup><\/span>. Despite this progress, TEA remains an important treatment option for patients with advanced RA who have failed medical treatment<\/span>7<\/sup><\/span>. About 10-20% of patients with RA will have arthritic changes in the elbow<\/span>5<\/sup><\/span>. TEA is considered for Larsen stages 3 to 5 with functional loss, pain, and instability<\/span>5<\/sup><\/span>. Ideally, the patient should be older than 65 years old<\/span>5<\/sup><\/span>. TEA has demonstrated excellent outcomes in patients with RA, with a mean patient satisfaction of 9.2 out of a possible 10 points<\/span>7<\/sup><\/span>. A study by Mansat and colleagues demonstrated a 97% survival rate at 5 years and 85% at 10 years after TEA for RA with a minimum 2-year follow-up<\/span>7<\/sup><\/span>.<\/span><\/p>\n

Osteoarthritis<\/b> <\/span><\/span><\/h3>\n\n

Osteoarthritis (OA) is a degenerative joint disease that results in the breakdown of cartilage in the joints<\/span>7<\/sup><\/span>. In the elbow, OA can cause pain, stiffness, and limited range of motion<\/span>7<\/sup><\/span>. TEA is an option for patients with severe OA who have not had success with conservative treatment options such as medications or steroid injections<\/span>9<\/sup><\/span>. Patients with primary OA should be older than 65 years old and experience mid-arc pain with activity resulting from ulnotrochlear joint cartilage loss<\/span>5<\/sup><\/span>. The 10-year implant survival for TEA for primary OA is about 80-85%<\/span>5<\/sup><\/span>.<\/span><\/p>\n

Post-traumatic Arthritis<\/b> <\/span><\/span><\/h3>\n\n

Post-traumatic arthritis (PTA) is a form of arthritis that develops after an injury to the elbow joint<\/span>5<\/sup><\/span>. This can occur after a fracture, dislocation, or other significant trauma<\/span>5<\/sup><\/span>. PTA can cause pain, stiffness, and limited range of motion, similar to OA<\/span>5<\/sup><\/span>. TEA is an option for patients with advanced PTA who have not responded to non-surgical treatments<\/span>5<\/sup><\/span>. Acute complex, unreconstructable intra-articular distal humerus fractures in elderly patients with poor bony quality are an indication for TEA<\/span>5<\/sup><\/span>.<\/span><\/p>\n

Surgical Approaches<\/b> <\/span><\/span><\/h2>\n\n

Several surgical approaches can be used for TEA, each with its own advantages and disadvantages. The choice of approach depends on factors such as the patient’s anatomy, the type of implant being used, and the surgeon’s preference<\/span>10<\/sup><\/span>. Surgical techniques for TEA destabilize the elbow by removing the medial and lateral collateral ligaments and, frequently, the radiocapitellar articulation<\/span>11<\/sup><\/span>. In general, triceps-sparing approaches are preferable to triceps-reflecting approaches for all types of arthroplasty in fractures as they allow immediate rehabilitation with no need to protect a triceps repair and provide a more robust extensor mechanism<\/span>10<\/sup><\/span>. The most common approaches are:<\/span><\/p>\n

    \n
  1. Triceps-reflecting approach:<\/b> <\/span> This involves reflecting the triceps muscle from medial to lateral in continuity with the anconeus<\/span>5<\/sup><\/span>. It provides good exposure of the elbow joint but can be associated with triceps weakness or loss of elbow extension<\/span>5<\/sup><\/span>.<\/span><\/li>\n
  2. Triceps-splitting approach:<\/b> <\/span> This involves longitudinally dividing the triceps in continuity with forearm fascia over the dorsal ulna<\/span>5<\/sup><\/span>. It allows for extensor mechanism lengthening if needed<\/span>5<\/sup><\/span>.<\/span><\/li>\n
  3. Triceps-sparing approach:<\/b> <\/span> This approach preserves the triceps intraoperatively, but exposure can be challenging<\/span>5<\/sup><\/span>. It is often preferred for acute distal humerus fractures as it allows for earlier post-operative range of motion<\/span>5<\/sup><\/span>. A study on dogs showed that a lateral approach for TER resulted in more elbow extension and less collateral ligament constraint compared to a medial approach<\/span>12<\/sup><\/span>.<\/span><\/li>\n<\/ol>\n\n\n\n\n\n\n\n\n\n
    Approach<\/b> <\/span><\/th>\n Advantages<\/b> <\/span><\/th>\n Disadvantages<\/b> <\/span><\/th>\n<\/tr>\n<\/thead>\n
    Triceps-reflecting<\/span><\/td>\nGood exposure of the elbow joint<\/span><\/td>\nCan be associated with triceps weakness or loss of elbow extension<\/span><\/td>\n<\/tr>\n
    Triceps-splitting<\/span><\/td>\nAllows for extensor mechanism lengthening if needed<\/span><\/td>\n–<\/span><\/td>\n<\/tr>\n
    Triceps-sparing<\/span><\/td>\nPreserves the triceps intraoperatively, allows for earlier post-operative range of motion<\/span><\/td>\nExposure can be challenging<\/span><\/td>\n<\/tr>\n
    Triceps-On<\/span><\/td>\nLess invasive, maintains triceps strength, allows for early active motion exercises<\/span><\/td>\nDoes not provide the best exposure of the articular surfaces of the humerus<\/span><\/td>\n<\/tr>\n
    Triceps-Off<\/span><\/td>\nProvides the best exposure of the distal humerus for fracture fixation<\/span><\/td>\nCan cause triceps weakness and risk of triceps avulsion<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Implant Designs<\/b> <\/span><\/span><\/h2>\n\n

    Elbow replacement surgery was first described in the 1950s<\/span>14<\/sup><\/span>. TEA implants have evolved significantly over the years. During the 1970s, designs of total knee replacement evolved from uniaxial hinges briefly into unlinked components that relied entirely upon the intrinsic and extrinsic ligaments for stability, and then into the more intrinsically stable condylar-shaped designs, which by the end of the 1970s had become entirely similar to those used today<\/span>15<\/sup><\/span>. Early implants were constrained hinges that only allowed flexion and extension. These were associated with high failure rates due to loosening. Modern implants are typically semiconstrained, allowing for some degree of varus-valgus and rotational laxity. This reduces stress on the bone-cement interface and improves implant longevity. Normal elbow function requires slight side-to-side motion with a little rotation even as the joint is bending and straightening<\/span>16<\/sup><\/span>. Reproducing all of that with a metal implant is a challenge<\/span>16<\/sup><\/span>. Elbow kinematics are important<\/span>6<\/sup><\/span>. Even optimal implant positioning can lead to 4-6mm of anterodistal translation in the axis of rotation without detrimental consequence<\/span>6<\/sup><\/span>.<\/span><\/p>\n

    The most common types of TEA implant designs are:<\/span><\/p>\n

      \n
    1. Unconstrained (unlinked):<\/b> <\/span> The concept and objective of unlinked TEA are to share the loading stress on the bone-implant interface with the surrounding tissues<\/span>17<\/sup><\/span>. These implants rely on the surrounding soft tissues for stability. They may be associated with a lower risk of wear and loosening but can be prone to dislocation.<\/span><\/li>\n
    2. Semiconstrained (linked):<\/b> <\/span> These implants have a “sloppy hinge” that allows for some varus-valgus and rotational laxity<\/span>5<\/sup><\/span>. They offer good stability and have shown the best results among all designs<\/span>5<\/sup><\/span>. With TEA, semiconstrained implants provide the best longevity and most optimal functional outcomes<\/span>5<\/sup><\/span>. The component stems (ulna and humerus) have improved fixation and reduced loosening<\/span>5<\/sup><\/span>. The humeral component extracortical anterior flange resists posteriorly directed and rotational forces<\/span>5<\/sup><\/span>.<\/span><\/li>\n
    3. Constrained:<\/b> <\/span> These implants have a rigid hinge design and are theoretically the most stable<\/span>5<\/sup><\/span>. However, they have the highest loosening rates compared to other designs<\/span>5<\/sup><\/span>. They were determined to have no indication for use in elbow arthroplasty due to their high failure rate<\/span>11<\/sup><\/span>.<\/span><\/li>\n<\/ol>\n

      Comparison of Surgical Approaches and Implant Designs<\/b> <\/span><\/span><\/h2>\n\n

      Triceps-sparing approaches are preferable to triceps-reflecting approaches for TEA in fractures<\/span>10<\/sup><\/span>. Triceps-on approaches are less invasive and maintain triceps strength, but they do not provide the best exposure of the articular surfaces of the humerus<\/span>13<\/sup><\/span>. Triceps-off approaches provide the best exposure of the distal humerus for fracture fixation, but they can cause triceps weakness and risk of triceps avulsion<\/span>13<\/sup><\/span>. Semiconstrained implants provide the best longevity and most optimal functional outcomes<\/span>5<\/sup><\/span>.<\/span><\/p>\n

      Long-Term Outcomes<\/b> <\/span><\/span><\/h2>\n\n

      TEA generally provides good pain relief and functional improvement in appropriately selected patients<\/span>18<\/sup><\/span>. A recent systematic review reported that approximately 60% of patients were pain-free at the latest follow-up (mean, 6.3 years)<\/span>17<\/sup><\/span>. The weighted mean difference of the flexion angle was 129\u00b0, and the weighted mean extension lag was 30\u00b0<\/span>17<\/sup><\/span>. The weighted mean supination was 66\u00b0, and the weighted mean pronation was 71\u00b0<\/span>17<\/sup><\/span>. A study with a minimum of 10 years of follow-up showed a significant improvement in average range of motion from 120\u00b0 to 140\u00b0 for flexion and from 40\u00b0 to 25\u00b0 for extension<\/span>19<\/sup><\/span>. Patients had an average Mayo Elbow Performance Score of 85<\/span>19<\/sup><\/span>. Another study reported a five-year implant survival of 91% for TEA<\/span>20<\/sup><\/span>. A systematic review of studies with long-term follow-up established that TEA offers patients satisfactory clinical outcomes, with relatively stable revision and complication rates<\/span>21<\/sup><\/span>. Selective use of TEA to treat fractures of the distal part of the humerus for infirm, less active older patients and patients with inflammatory arthritis has acceptable longevity in surviving patients, but at the cost of several major complications<\/span>22<\/sup><\/span>.<\/span><\/p>\n

      Potential Complications<\/b> <\/span><\/span><\/h2>\n\n

      Despite the advancements in implant design and surgical techniques, TEA is still associated with a relatively high complication rate compared to other joint replacements<\/span>15<\/sup><\/span>. The TEA is at risk of loosening and failure with overuse and weight-bearing, and has a reported rate of need for revision surgery between 5-15%<\/span>14<\/sup><\/span>. Potential complications include:<\/span><\/p>\n

        \n
      1. Infection:<\/b> <\/span> Infection is a concern with any surgery, and TEA is no exception<\/span>23<\/sup><\/span>. The risk of infection is higher in patients with RA or those who have had previous elbow surgery<\/span>23<\/sup><\/span>.<\/span><\/li>\n
      2. Loosening:<\/b> <\/span> Implant loosening can occur over time due to wear and tear or osteolysis<\/span>23<\/sup><\/span>. This may require revision surgery<\/span>23<\/sup><\/span>.<\/span><\/li>\n
      3. Instability:<\/b> <\/span> Instability is more common with unlinked implants and can lead to dislocation<\/span>23<\/sup><\/span>.<\/span><\/li>\n
      4. Fracture:<\/b> <\/span> Fractures can occur during or after surgery, particularly in patients with osteoporosis<\/span>23<\/sup><\/span>.<\/span><\/li>\n
      5. Nerve injury:<\/b> <\/span> The ulnar nerve, which runs along the inside of the elbow, is at risk of injury during TEA<\/span>23<\/sup><\/span>. Most nerve injuries recover over time<\/span>23<\/sup><\/span>.<\/span><\/li>\n
      6. Triceps insufficiency:<\/b> <\/span> This can occur if the triceps tendon is detached during surgery and fails to heal properly<\/span>23<\/sup><\/span>. Triceps insufficiency can commonly occur after a failed surgical reattachment, particularly when tendon quality is poor or a traumatic rupture of the tendon is present<\/span>17<\/sup><\/span>.<\/span><\/li>\n
      7. Periprosthetic fracture:<\/b> <\/span> These are fractures that occur around the implant and can be caused by trauma, poor implant alignment, or the patient’s activities<\/span>16<\/sup><\/span>.<\/span><\/li>\n<\/ol>\n

        Postoperative Care<\/b> <\/span><\/span><\/h2>\n\n

        The postoperative management of TEA has not been widely discussed in the current literature, and no standardized post-TEA protocol exists<\/span>24<\/sup><\/span>. It is hypothesized that this leads to variable and inconsistent postoperative care<\/span>24<\/sup><\/span>.<\/span><\/p>\n

        Conclusion<\/b> <\/span><\/span><\/h2>\n\n

        Total elbow arthroplasty is an effective treatment option for patients with severe elbow joint damage caused by conditions such as RA, OA, and PTA<\/span>18<\/sup><\/span>. Modern implant designs and surgical techniques have improved the long-term outcomes and reduced the complication rates associated with TEA<\/span>21<\/sup><\/span>. However, it is essential to carefully select patients and counsel them about the potential risks and benefits of the procedure<\/span>20<\/sup><\/span>. Despite the increasing use of TEA, long-term complications remain a challenge, partly due to the relative rarity of the procedure and the limited experience of many surgeons<\/span>17<\/sup><\/span>. The changing patient population undergoing TER impacts implant selection and long-term outcomes<\/span>15<\/sup><\/span>. Future research should focus on further improving implant designs, surgical techniques, and rehabilitation protocols to optimize the outcomes of TEA and minimize complications. More research is needed on the postoperative management of TEA. The development of standardized post-TEA protocols could help to improve outcomes and reduce variability in care.<\/span><\/p>\n

        Works cited<\/b><\/span><\/h4>\n\n

        1. Total Elbow Replacement Seattle | Elbow Joint Pain Tacoma | Elbow Arthroplasty Bellevue, accessed February 17, 2025, https:\/\/www.kevinkomd.com\/total-elbow-replacement-shoulder-elbow-specialist-seattle-bellevue-wa.html<\/a><\/p>\n

        2. Total Elbow Arthroplasty – PMC – PubMed Central, accessed February 17, 2025, https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC3093740\/<\/a><\/p>\n

        3. Elbow replacement surgery – Mayo Clinic, accessed February 17, 2025, https:\/\/www.mayoclinic.org\/tests-procedures\/elbow-replacement-surgery\/about\/pac-20385126<\/a><\/p>\n

        4. Global trends in indications for total elbow arthroplasty: a systematic review of national registries in, accessed February 17, 2025, https:\/\/eor.bioscientifica.com\/view\/journals\/eor\/5\/4\/2058-5241.5.190036.xml<\/a><\/p>\n

        5. Total Elbow Arthroplasty – Shoulder & Elbow – Orthobullets, accessed February 17, 2025, https:\/\/www.orthobullets.com\/shoulder-and-elbow\/3089\/total-elbow-arthroplasty<\/a><\/p>\n

        6. COMPLICATIONS OF TOTAL ELBOW ARTHROPLASTY SUBSPECIALTY, accessed February 17, 2025, https:\/\/orthojournalhms.org\/volume12\/manuscripts\/PDF\/20.pdf<\/a><\/p>\n

        7. Elbow Replacement, Elbow Arthroplasty, Orthopaedic Surgeons – Orthosports, accessed February 17, 2025, https:\/\/orthosports.com.au\/elbow\/total-elbow-replacement\/<\/a><\/p>\n

        8. Global trends in indications for total elbow arthroplasty: a systematic review of national registries – PMC, accessed February 17, 2025, https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC7202040\/<\/a><\/p>\n

        9. Total Elbow Replacement, Fort Worth TX | Donald Dolce, MD, accessed February 17, 2025, https:\/\/www.donalddolcemd.com\/total-elbow-replacement-orthopedic-surgeon-fort-worth-texas.html<\/a><\/p>\n

        10. Total elbow arthroplasty – AO Surgery Reference, accessed February 17, 2025, https:\/\/surgeryreference.aofoundation.org\/orthopedic-trauma\/adult-trauma\/distal-humerus\/basic-technique\/total-elbow-arthroplasty<\/a><\/p>\n

        11. www.arrchorthopaedics.com, accessed February 17, 2025, https:\/\/www.arrchorthopaedics.com\/uploads\/1\/3\/2\/6\/132641762\/kaufmann_tea_biomech_failure.pdf<\/a><\/p>\n

        12. A lateral approach allows accurate and stable total elbow replacement in dogs in – AVMA Journals, accessed February 17, 2025, https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/85\/9\/ajvr.24.04.0100.xml<\/a><\/p>\n

        13. Comprehensive review of surgical approaches to the elbow – PMC, accessed February 17, 2025, https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8254122\/<\/a><\/p>\n

        14. Total Elbow Replacement – Dr Benjamin W Sears | Orthopaedic Specialist Denver, accessed February 17, 2025, https:\/\/www.denvershoulderandelbow.com\/orthopaedic-specialist-denver-arvada-total-elbow-replacement.html<\/a><\/p>\n

        15. Total elbow replacement \u2013 patient selection and perspectives | ORR – Dove Medical Press, accessed February 17, 2025, https:\/\/www.dovepress.com\/total-elbow-replacement-ndash-patient-selection-and-perspectives-peer-reviewed-fulltext-article-ORR<\/a><\/p>\n

        16. Six Disabling Complications of Elbow Replacement – South Mountain Physical Therapy, accessed February 17, 2025, https:\/\/www.southmountainpt.com\/Injuries-Conditions\/Elbow\/Research-Articles\/Six-Disabling-Complications-of-Elbow-Replacement\/a~4413\/article.html<\/a><\/p>\n

        17. Total Elbow Arthroplasty: Clinical Outcomes, Complications, and Revision Surgery – PMC, accessed February 17, 2025, https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC6867907\/<\/a><\/p>\n

        18. Periprosthetic Infection Following Total Elbow Arthroplasty: A Case …, accessed February 17, 2025, https:\/\/orthojournalhms.org\/20\/article46_51.html<\/a><\/p>\n

        19. Total elbow arthroplasty yielded high complication, revision rate among young patients, accessed February 17, 2025, https:\/\/www.healio.com\/news\/orthopedics\/20200428\/total-elbow-arthroplasty-yielded-high-complication-revision-rate-among-young-patients<\/a><\/p>\n

        20. Implant survival of total elbow arthroplasty: analysis of 514 cases from the Dutch Arthroplasty Registry | Bone & Joint, accessed February 17, 2025, https:\/\/boneandjoint.org.uk\/Article\/10.1302\/2633-1462.42.BJO-2022-0152.R1<\/a><\/p>\n

        21. Long-term outcomes of total elbow arthroplasty: a systematic review of studies at 10-year follow-up – PubMed, accessed February 17, 2025, https:\/\/pubmed.ncbi.nlm.nih.gov\/33418089\/<\/a><\/p>\n

        22. Total Elbow Arthroplasty for Distal Humeral Fractures – Orthobullets, accessed February 17, 2025, https:\/\/upload.orthobullets.com\/journalclub\/free_pdf\/28926381_Total%20Elbow%20Arthroplasty%20for%20Distal%20Humeral%20Fractures.pdf<\/a><\/p>\n

        23. Total Elbow Replacement – Arm Docs, accessed February 17, 2025, https:\/\/www.armdocs.com\/treatment\/total-elbow-replacement<\/a><\/p>\n

        24. Postoperative management of total elbow arthroplasty: Results of a European survey among orthopedic surgeons | PLOS ONE, accessed February 17, 2025, https:\/\/journals.plos.org\/plosone\/article?id=10.1371\/journal.pone.0277662<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

        Total Elbow Arthroplasty: A Comprehensive Review Total elbow arthroplasty (TEA) is a surgical procedure in which a surgeon replaces damaged portions of the elbow joint with an artificial joint. This procedure is a treatment option for patients with end-stage arthritis of the elbow joint1. When the cartilage in the joint is worn out, it can […]<\/p>\n","protected":false},"author":1,"featured_media":5456,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[531],"tags":[953,835,952,954,339,162,955,159,839,951],"class_list":["post-5457","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-hand-upper-extremity-restoring-function-and-dexterity","tag-artificial-joint","tag-distal-humerus-fractures","tag-elbow-joint","tag-end-stage-arthritis","tag-inflammatory-arthritis","tag-osteoarthritis","tag-post-traumatic-arthritis","tag-rheumatoid-arthritis","tag-surgical-approaches","tag-total-elbow-arthroplasty"],"_links":{"self":[{"href":"https:\/\/www.orthogate.org\/press\/wp-json\/wp\/v2\/posts\/5457","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.orthogate.org\/press\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.orthogate.org\/press\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.orthogate.org\/press\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.orthogate.org\/press\/wp-json\/wp\/v2\/comments?post=5457"}],"version-history":[{"count":0,"href":"https:\/\/www.orthogate.org\/press\/wp-json\/wp\/v2\/posts\/5457\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.orthogate.org\/press\/wp-json\/wp\/v2\/media\/5456"}],"wp:attachment":[{"href":"https:\/\/www.orthogate.org\/press\/wp-json\/wp\/v2\/media?parent=5457"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.orthogate.org\/press\/wp-json\/wp\/v2\/categories?post=5457"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.orthogate.org\/press\/wp-json\/wp\/v2\/tags?post=5457"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}