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Related Experiment Video

Updated: Jun 12, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
09:01

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

Published on: January 24, 2018

Failure patterns after linked semiconstrained total elbow arthroplasty for posttraumatic arthritis.

Thomas Throckmorton1, Peter Zarkadas, Joaquin Sanchez-Sotelo

  • 1Department of Orthopedics, Mayo Clinic, Rochester, MN 55906, USA.

The Journal of Bone and Joint Surgery. American Volume
|June 3, 2010
PubMed
Summary

Total elbow arthroplasty for posttraumatic arthritis has a high failure rate, especially in patients under 60. Understanding failure modes like infection and wear can improve implant design and surgical techniques.

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Engineering
  • Reconstructive Surgery

Background:

  • Posttraumatic arthritis often necessitates total elbow arthroplasty.
  • Semiconstrained total elbow arthroplasty (TEA) demonstrates a notable failure rate in treating posttraumatic arthritis.
  • Identifying failure mechanisms is crucial for enhancing implant design and surgical procedures.

Purpose of the Study:

  • To analyze the failure modes and long-term outcomes of semiconstrained total elbow arthroplasty in patients with posttraumatic arthritis.
  • To identify patient demographics and failure patterns associated with revision or resection.

Main Methods:

  • Eighty-five semiconstrained total elbow arthroplasties were performed on 84 patients for posttraumatic arthritis.
  • Sixty-nine primary prostheses were followed for an average of 9 years, with clinical outcomes assessed using the Mayo Elbow Performance Score.

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  • Radiographs were evaluated for mechanical failure, and all complications were meticulously recorded.

    • Main Results:

    • A 19% failure rate (16 of 85 primary arthroplasties) was observed, with causes including bushing wear (7), infection (4), component fracture (3), and loosening (2).
    • Early failures (<5 years) were primarily due to infection, while intermediate-term failures (5-10 years) were linked to bushing wear.
    • Seventy-five percent of failures occurred in patients under 60 years old. Despite failures, significant improvements in pain, motion, and Mayo Elbow Performance Scores were noted, with a 15-year survival rate of 70%.

    Conclusions:

    • Semiconstrained TEA for posttraumatic arthritis imposes significant demands, leading to a high failure rate, particularly in patients under 60.
    • Infection is a common cause of early failure, whereas bushing wear and component fracture/loosening dominate intermediate and late-term failures.
    • While aseptic loosening is less common, understanding these failure modes is critical for improving long-term implant survival and patient satisfaction.