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Updated: Jun 22, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Total elbow arthroplasty in patients forty years of age or less
Andrea Celli1, Bernard F Morrey
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Insights
Total elbow arthroplasty in patients under forty had a 22% revision rate, with higher rates for posttraumatic arthritis. However, 93% of patients achieved good or excellent outcomes, demonstrating the procedure
Area of Science:
- Orthopedic surgery
- Arthroplasty
- Prosthetic joint replacement
Background:
- Total elbow arthroplasty is generally avoided in young patients due to high early failure rates.
- This study investigates outcomes in patients aged 40 or younger undergoing semiconstrained total elbow arthroplasty.
Purpose of the Study:
- To define success rates, prosthetic survival, and complications of semiconstrained total elbow arthroplasty in patients aged 40 or younger.
Main Methods:
- Retrospective review of 55 total elbow arthroplasties in 49 patients (age ≤ 40) between 1982-2003.
- Minimum 5-year follow-up; Mayo Elbow Performance Score used for assessment.
- Indications included inflammatory (30) and posttraumatic (19) arthritis.
Main Results:
- Mean follow-up was 91 months.
- 22% revision rate (12 elbows) due to loosening, triceps weakness, wear, or infection.
- 65% excellent and 27% good Mayo Elbow Performance Scores (93% combined).
Conclusions:
- Semiconstrained total elbow arthroplasty in young patients has a 22% revision rate, higher in posttraumatic cases.
- Despite revisions, 93% of patients achieved good or excellent functional outcomes.
- This suggests potential benefits in carefully selected young patients.
Background:
It is generally accepted that prosthetic elbow replacement should be avoided in young patients because of an anticipated high rate of early failure. The purpose of this paper was to define the success, prosthetic survival rate, and problems encountered in patients who were treated with a semiconstrained total elbow arthroplasty when they were forty years of age or less.
Methods:
We retrospectively reviewed the records of 758 patients who had undergone primary arthroplasty with the Coonrad-Morrey total elbow prosthesis for any reason between 1982 and 2003. We identified fifty-five total elbow arthroplasties that had been performed in forty-nine patients (thirty-eight women and eleven men) who were forty years of age or less (mean, thirty-three years) at the time of the operation and that had been followed for a minimum of five years. Six patients had a bilateral procedure. The indication for the arthroplasty was inflammatory arthritis in thirty patients and posttraumatic arthritis in nineteen. Patients with hemophilia or a neoplasm were excluded. The medical record data were used to calculate the preoperative and postoperative Mayo Elbow Performance Score.
Results:
The mean duration of follow-up was ninety-one months. During this period, twelve (22%) of the elbows had undergone a subsequent surgical procedure: four because of loosening, three because of triceps weakness, three because of wear, and two because of deep infection. On the basis of the Mayo Elbow Performance Score at the last review, thirty-six results (65%) were considered to be excellent; fifteen (27%), good; three (5%), fair; and one (2%), poor.
Conclusions:
Semiconstrained total elbow arthroplasty in young patients was associated with a 22% revision rate at a mean of ninety-one months, and the rate of revision was significantly higher for patients with posttraumatic arthritis. Despite this revision rate, fifty-one elbows (93%) had a good or excellent Mayo Elbow Performance Score.