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Primary total elbow arthroplasty.

Suresh Kumar1, Sunayan Mahanta1

  • 1Department of Orthopedics, Maharishi Valmiki Hospital, Pooth Khurd, Delhi, India.

Indian Journal of Orthopaedics
|January 1, 2014
PubMed
Summary
This summary is machine-generated.

Primary total elbow arthroplasty (TEA) is a valuable option for patients with severe elbow deformities and ankylosis. This study shows TEA can restore function, though some cases may require revision surgery for ulnar stem loosening.

Keywords:
Ankylosiscomminuted fracture of distal humerustotal elbow arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery

Background:

  • Total elbow arthroplasty (TEA) is a complex orthopedic procedure, less common than hip or knee replacements.
  • The elbow joint experiences significant forces, necessitating robust reconstructive options for severe damage.
  • Arthroplasty is a viable treatment for elderly patients with elbow deformities and ankylosis due to arthritis or fractures.

Purpose of the Study:

  • To evaluate the efficacy of primary total elbow arthroplasty (TEA) in managing severe elbow deformities.
  • To analyze the functional outcomes and potential complications associated with TEA in a specific patient cohort.

Main Methods:

  • A retrospective analysis of 11 primary total elbow arthroplasty (TEA) cases performed between 2002 and 2012.
  • Patients with indications including rheumatoid arthritis, complex distal humerus fractures, and post-traumatic ankylosis were included.
  • The Baksi sloppy (semi-constrained) hinge prosthesis was utilized, with clinical and radiological follow-up.

Main Results:

  • Significant improvements in range of motion were observed, with average flexion of 135°, supination of 70°, and pronation of 70°.
  • The mean Mayo elbow performance score was high at 95.4, indicating good functional recovery.
  • Complications included loss of extension in 5 cases and ulnar stem radiolucency/loosening in 2 cases (18%), with one requiring revision surgery.

Conclusions:

  • Primary total elbow arthroplasty (TEA) is an effective treatment for debilitating elbow deformities and ankylosis.
  • While TEA offers significant functional restoration, potential long-term complications like ulnar stem loosening should be monitored.
  • This procedure remains a valuable option for patients with severe elbow conditions, particularly those with high functional demands.