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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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Component fracture after total elbow arthroplasty
Homin Lee1, Anthony M Vaichinger2, Shawn W O'Driscoll2
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, College of Medicine, Dongguk University, Gyeongju, Republic of Korea.
Journal of Shoulder and Elbow Surgery
|May 12, 2019
Summary
Component stem fractures in total elbow arthroplasty (TEA) are fatigue failures. These fractures result from osteolysis caused by bushing wear, leading to unsupported stem sections and subsequent component failure.
Area of Science:
- Orthopedic surgery
- Biomaterials engineering
- Failure analysis
Background:
- Component stem fractures are serious complications following total elbow arthroplasty (TEA).
- These fractures are hypothesized to be fatigue failures initiated by periarticular osteolysis.
- Osteolysis is often linked to wear debris generated from bushing components.
Purpose of the Study:
- To investigate the mechanism of component stem fractures in TEA.
- To determine the relationship between bushing wear, osteolysis, and stem fracture location.
- To identify factors contributing to fatigue failure of TEA components.
Main Methods:
- Retrospective review of 2637 primary and revision TEA cases (1972-2016).
- Analysis of 47 cases with component stem fractures.
- Quantification of bushing wear and assessment of periarticular osteolysis on radiographs.
Main Results:
- Severe bushing wear was present in 34 of 39 cases with quantifiable wear.
- All 47 cases exhibited periarticular osteolysis.
- Stem fractures predominantly occurred at the junction of supported and unsupported stem segments, consistent with fatigue failure.
Conclusions:
- Component stem fractures in TEA result from fatigue failure at the interface of supported and unsupported stem regions.
- Periarticular osteolysis, driven by bushing wear, creates the unsupported stem region.
- Addressing bushing wear is crucial for preventing component stem fractures in TEA.
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