Total elbow arthroplasty in distal humeral nonunion: clinical and radiographic evaluation after a minimum follow-up of three years

Background Total elbow arthroplasty is a low volume procedure. We aimed to evaluate complication rates and cumulative percentages associated with the most frequently used contemporary implants and for the commonest indications. Methods A systematic literature search of all studies reporting complications following total elbow arthroplasty with 12-month minimum follow-up was undertaken. Quality of studies was assessed with the Methodological-Index-for-Non-Randomised-studies criteria. British NJR data identified the most common UK prostheses and indications. The complication rates for all undesirable events contributing to patient outcome were extracted and cumulative percentages were calculated. Results One hundred seventeen studies were screened, 12 studies included, totalling 815 procedures. Mean follow-up was 3.8 years. The overall complication cumulative percentage was 60.7%, significantly higher than that seen in other joint arthroplasty, including a 6.5% deep infection rate. Nerve injury was comparable between implants at around 4.1%. Radiographic loosening had a cumulative rate of 17.2%. Revision for symptomatic aseptic loosening was 6.3%. Conclusions This is the largest systematic review of the complications of total elbow arthroplasty. Surgeons should be aware of differing complications related to their implant of choice, each having its own specific complication. Trauma as an indication appears to have an increased complication rates compared to inflammatory arthropathy. There is a lack of literature regarding the independent results of osteoarthritis as a specific indication for total elbow arthroplasty.

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Clinical outcomes and complications following primary total elbow arthroplasty using the Latitude prosthesis

Shoulder & Elbow ◽

10.1177/1758573218768510 ◽

2018 ◽

Vol 11 (5) ◽

pp. 359-371 ◽

Cited By ~ 1

Author(s):

David Cinats ◽

Aaron J Bois ◽

Kevin A Hildebrand

Keyword(s):

Range Of Motion ◽

Clinical Outcomes ◽

Total Elbow Arthroplasty ◽

Published Data ◽

Mayo Elbow Performance Score ◽

Elbow Arthroplasty ◽

Radiographic Outcomes ◽

Flexion Extension ◽

Functional Outcome Measures

Background The Latitude total elbow arthroplasty (TEA) is an implant with limited published data on its performance and outcomes. The aim of this study was to report the short-term outcomes of the Latitude TEA as well as to describe the radiographic outcomes and complications. Methods The Latitude was implanted in 20 patients (23 elbows) in a linked configuration. Patients were recalled to clinic for the assessment of their range-of-motion and compared to preoperative values. Administration of functional outcome measures was also performed. Results Mean follow-up was 4.7 years (range, 1 to 7.5 years) with four elbows requiring revision. The flexion–extension arc improved from 86.6 to 101.3 (range, 76 to 126) postoperatively (p = 0.04). The average Disabilities of the Arm, Shoulder, and Hand score was 28.1 (range, 5.8 to 50.4) and the average Mayo Elbow Performance Score was 89.6 (range, 76 to 100), with 83% of elbows scoring in the good or excellent range. Radiolucencies were detected in 60% of patients and 31% of these lucencies progressed in size at the time of follow-up. Conclusions The Latitude prosthesis provides patients with favorable clinical outcomes with improvements in their range-of-motion and a complication rate comparable to other elbow arthroplasty implants.

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Results with a minimum of 10 years follow-up of the Coonrad/Morrey total elbow arthroplasty

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2013.07.002 ◽

2013 ◽

Vol 99 (6) ◽

pp. S337-S343 ◽

Cited By ~ 31

Author(s):

P. Mansat ◽

N. Bonnevialle ◽

M. Rongières ◽

M. Mansat ◽

P. Bonnevialle

Keyword(s):

Total Elbow Arthroplasty ◽

Elbow Arthroplasty

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Heterotopic ossification following total elbow arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.100b6.bjj-2017-0535.r2 ◽

2018 ◽

Vol 100-B (6) ◽

pp. 767-771 ◽

Cited By ~ 5

Author(s):

P. M. Robinson ◽

S. J. MacInnes ◽

D. Stanley ◽

A. A. Ali

Keyword(s):

Retrospective Study ◽

Heterotopic Ossification ◽

Clinical Outcomes ◽

Total Elbow Arthroplasty ◽

Range Of Movement ◽

Exact Test ◽

Elbow Arthroplasty ◽

Fisher’S Exact Test ◽

Trauma Group

Aim The primary aim of this retrospective study was to identify the incidence of heterotopic ossification (HO) following elective and trauma elbow arthroplasty. The secondary aim was to determine clinical outcomes with respect to the formation of heterotopic ossification. Patients and Methods A total of 55 total elbow arthroplasties (TEAs) (52 patients) performed between June 2007 and December 2015 were eligible for inclusion in the study (29 TEAs for primary elective arthroplasty and 26 TEAs for trauma). At review, 15 patients (17 total elbow arthroplasties) had died from unrelated causes. There were 14 men and 38 women with a mean age of 70 years (42 to 90). The median clinical follow-up was 3.6 years (1.2 to 6) and the median radiological follow-up was 3.1 years (0.5 to 7.5). Results The overall incidence of HO was 84% (46/55). This was higher in the trauma group (96%, 25/26) compared with the elective arthroplasty group (72%, 21/29) (p = 0.027, Fisher’s exact test). Patients in the trauma group had HO of higher Brooker class. The presence of HO did not significantly affect elbow range of movement within the trauma or elective groups (elective arthroplasty, Mann–Whitney U test, p = 0.070; trauma arthroplasty, p = 0.370, Mann–Whitney U test). Conclusion HO after total elbow arthroplasty is seen more commonly than previously reported. We have reported a significantly higher rate of HO in TEAs performed for trauma than those performed electively. Cite this article: Bone Joint J 2018;100-B:767–71.

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Establishing the Role of Unlinked Total Elbow Arthroplasty in Low Demand Patients: A Long-Term Follow-up Study

Acta Médica Portuguesa ◽

10.20344/amp.6064 ◽

2016 ◽

Vol 29 (6) ◽

pp. 367

Author(s):

Sara Machado ◽

Isabel Almeida Pinto ◽

Rui Pinto ◽

Paulo Ribeiro de Oliveira

Keyword(s):

Range Of Motion ◽

Total Elbow Arthroplasty ◽

Great Loss ◽

Elbow Arthroplasty ◽

Mayo Score ◽

Long Term Follow Up ◽

Limiting Condition ◽

Mayo Elbow Score

Introduction: Experience with total elbow arthroplasty is scarce in most centers. It seems to have a significant rate of associated complications. Most studies are based on non-validated outcome measures and short-term results. Material and Methods: We selected patients undergoing unlinked total elbow arthroplasty, with a resultant sample of thirteen cases, with a mean postoperative follow-up of 72 months. We applied the Mayo Elbow Score and all patients underwent an X-ray study, prior to surgery and during the follow-up period. Results: All patients have a systemic inflammatory condition. The mean Mayo score increased from 43 points preoperatively to 70 and 80 points at the intermediate follow-up period (with a mean of 15 months after the operation) and at the time of the latest follow-up evaluation (with a mean of 72 months after the operation). There was an increase in range of motion in all cases. There was one case of mechanical failure and two cases of transient ulnar neuropathy. Discussion: Elbow dysfunction causes great loss in patient´s quality of life, incapacitating them for the simplest activities. Small improvements in range of motion and pain relief result in significant changes in the patient’s functional ability. There is a demand to clarify the performance of total elbow arthroplasty in selected patient groups in order to throw more light on the relative roles of the available implants. Conclusions: The results obtained in this study seem to confirm the long-term benefit of the unlinked arthroplasty in severe joint dysfunction in patients with low physical demand, particularly in rheumatoid arthritis, a common and limiting condition in our population.

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