Total replacement for post-traumatic arthritis of the elbow

Area of Science:

• Orthopedic Surgery
• Biomaterials Science

Background:

• Post-traumatic arthritis of the elbow presents significant management challenges, often requiring multiple prior surgeries and resulting in limited function or complications.
• Patients frequently have complex histories, including previous surgeries, joint stiffness, instability, or prior complications, making treatment decisions difficult.

Purpose of the Study:

• To evaluate the long-term outcomes of Coonrad prosthesis implantation for post-traumatic elbow arthritis.
• To assess the reliability and complication rates associated with this implant in a challenging patient cohort.

Main Methods:

• A retrospective follow-up of 55 consecutive elbow replacements using the Coonrad prosthesis for post-traumatic arthritis.
• Minimum two-year follow-up (mean 6.3 years) on 53 patients, analyzing revision rates, radiolucency, and functional outcomes.
• Detailed review of patient histories, including previous operations, complications, and pre-operative range of motion.

Main Results:

• Of 53 patients followed, 38 elbows showed no progressive radiolucent lines at follow-up.
• 10 patients (14 revisions) required further surgery, primarily for aseptic loosening.
• Two elbows were resected due to deep infection or bone resorption secondary to a foreign-body reaction.

Conclusions:

• The Coonrad prosthesis is a reliable option for treating post-traumatic elbow arthritis.
• Careful patient selection, particularly for individuals over 60 years old, is crucial for optimal outcomes.
• While effective, the prosthesis is associated with risks such as aseptic loosening and infection, necessitating vigilant monitoring.