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Revision Total Elbow Arthroplasty.

Louis C Grandizio1, A Michael Luciani1, Jessica L Koshinski1

  • 1Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA.

The Journal of Hand Surgery
|October 25, 2024
PubMed
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Revision total elbow arthroplasty (TEA) has higher early failure rates than hip or knee replacements. This review covers diagnosing and managing failed primary TEA, focusing on infection, fracture, and bone loss challenges.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Arthroplasty Research

Background:

  • Total elbow arthroplasty (TEA) shows higher early revision rates compared to hip and knee arthroplasty.
  • Revision TEA is a necessary but complex procedure associated with significant patient morbidity.
  • Advances in biomechanics and implant design have not fully mitigated early failure risks.

Purpose of the Study:

  • To review the diagnosis and management strategies for failed primary total elbow arthroplasty.
  • To discuss current surgical concepts for revision TEA, including indications like infection, fracture, and osteolysis.
  • To explore techniques for addressing bone loss in revision elbow surgery.

Main Methods:

  • Literature review of diagnostic criteria for failed TEA.
Keywords:
Aseptic osteolysisperiprosthetic fractureprosthetic joint infectionrevision total elbow arthroplastytotal elbow arthroplasty

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  • Analysis of current surgical approaches for revision TEA.
  • Examination of strategies for managing bone defects in revision arthroplasty.

    • Main Results:

    • Early revision of TEA is a significant clinical concern.
    • Prosthetic joint infection, periprosthetic fracture, and aseptic osteolysis are key indications for revision.
    • Bone loss presents a major challenge in revision TEA, requiring specialized techniques.

    Conclusions:

    • Effective diagnosis and management are crucial for improving outcomes in revision TEA.
    • Addressing infection, fracture, and aseptic loosening requires tailored surgical interventions.
    • Strategies for bone reconstruction are vital for successful revision total elbow arthroplasty.