Elbow lengthening after total prosthetic arthroplasty: Observations and clinical implications

We have carried out a radiologic study to determine the effect on limb length of inserting the components of a total elbow joint replacement arthroplasty. The preoperative and postoperative radiographs of 27 consecutive patients undergoing total elbow joint replacement arthroplasty with the Kudo prosthesis were studied. In all cases lengthening across the elbow was found. Both ulnar and humeral lengthening were observed. A mean length increase of 8.6 mm (range 2 to 17 mm) was recorded. Ulnar lengthening contributed to overall lengthening by a significantly greater amount than humeral lengthening. We correlated the degree of lengthening observed with clinical measurements in this series of patients but found no significant differences. Operative maneuvers are suggested to accommodate this length increase, to achieve soft-tissue balance, and to avoid potential complications such as ulnar neuropathy and joint instability.