Total elbow arthroplasty for primary osteoarthritis

Bradley S. Schoch, Jean David Werthel, Joaquín Sánchez-Sotelo, Bernard F. Morrey, Mark Morrey

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Background Primary osteoarthritis of the elbow is a less common indication for total elbow arthroplasty (TEA). Higher complication rates in younger, active patients may offset short-term improvements in pain and function. The purpose of this study was to determine pain relief, functional outcomes, complications, and survival of TEA in this population. Methods Between 1984 and 2011, 20 consecutive TEAs were performed for primary elbow osteoarthritis. Two patients died before the 2-year follow-up. Mean age at surgery was 68 years (range, 51-85 years). Outcome measures included pain, motion, Mayo Elbow Performance Score, satisfaction, complications, and reoperations. Mean follow-up was 8.9 years (range, 2-20 years). Results Three elbows sustained mechanical failures. Complications included intraoperative fracture (n = 2), wound irrigation and débridement (n = 1), bony ankylosis (n = 1), humeral loosening (n = 1), humeral component fracture (n = 1), and mechanical failure of a radial head component (n = 1). Fifteen elbows without mechanical failure were examined clinically. Pain improved from 3.6 to 1.5 (P <.001). Range of motion remained clinically unchanged (P >.05), with preoperative flexion contractures not improving. Mayo Elbow Performance Scores were available for 13 elbows without mechanical failure, averaging 81.5 points (range, 60-100 points); these were graded as excellent (n = 5), good (n = 2), and fair (n = 6). Subjectively, all patients without mechanical failure were satisfied. Conclusion TEA represents a reliable surgical option for pain relief in patients with primary osteoarthritis. However, restoration of extension is not always obtained, indicating that more aggressive soft tissue releases or bony resection should be considered. Complications occurred in a large number of elbows, but mechanical failure was low considering the nature of this population and the length of follow-up.

Original languageEnglish (US)
Pages (from-to)1355-1359
Number of pages5
JournalJournal of Shoulder and Elbow Surgery
Volume26
Issue number8
DOIs
StatePublished - Aug 2017
Externally publishedYes

Keywords

  • active
  • complications
  • primary osteoarthritis
  • Total elbow
  • total elbow arthroplasty
  • young

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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