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[Endoprosthesis implantation in the elbow joint]
A G Schneeberger1, D C M Meyer
1Orthopädische Universitätsklinik Balgrist, Zürich. schneeberger.a@balgrist.ch
Therapeutische Umschau. Revue Therapeutique
|November 14, 2002
Summary
The Coonrad-Morrey prosthesis offers improved total elbow replacement outcomes, significantly reducing loosening rates compared to older designs. This semiconstrained implant is suitable for diverse indications, providing favorable function and pain relief for many patients.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Reconstructive Surgery
Background:
- Early constrained hinged total elbow prostheses had high loosening rates due to direct force transmission to the bone.
- Subsequent resurfacing implants improved loosening rates but require intact condyles and ligaments, limiting indications.
- The Coonrad-Morrey prosthesis represents a significant advancement in total elbow arthroplasty design.
Purpose of the Study:
- To evaluate the clinical outcomes and long-term efficacy of the Coonrad-Morrey total elbow prosthesis.
- To compare the performance of the Coonrad-Morrey prosthesis with previous total elbow implant designs.
- To assess the suitability of the Coonrad-Morrey prosthesis for various etiological conditions of elbow joint destruction.
Main Methods:
- Review of clinical results for the Coonrad-Morrey semiconstrained prosthesis in patients with rheumatoid arthritis and posttraumatic arthrosis.
- Analysis of loosening rates, functional restoration (flexion, extension, rotation), and complication rates.
- Comparison of outcomes with historical data from constrained hinged and resurfacing elbow prostheses.
Main Results:
- The Coonrad-Morrey prosthesis demonstrates a low loosening rate (4% at 10 years for rheumatoid arthritis), comparable to hip and knee replacements.
- Favorable long-term outcomes in rheumatoid arthritis (96% good/very good results) with restored function (131° flexion, 28° extension loss).
- Satisfactory results (83%) in posttraumatic arthrosis, though complication rates are higher (30%), contraindicating strenuous activities.
Conclusions:
- The Coonrad-Morrey total elbow prosthesis is a reliable option with significantly improved survivorship and broad applicability.
- Its semiconstrained design effectively manages joint forces, making it suitable for severe elbow destruction and loss of distal humerus.
- While effective for pain relief and function, patient selection is crucial, especially regarding activity levels due to potential complications.