Techniques for removal of well-fixed implants and cement in revision total elbow arthroplasty

Revision total elbow arthroplasty (rTEA) is a technically challenging procedure that is associated with high rates of surgical complications. Cement removal remains an important and difficult component of rTEA. Particularly in the case of prosthetic joint infection following TEA, failure to remove all of the cement from the index procedure results in higher rates of recurrent or persistent infection. Options for cement removal include the use of nonpowered instruments, powered instruments, ultrasonic devices, arthroscopic-assisted techniques, bone episiotomies, and cortical windows. Carefully assessing the risks and benefits of each of these techniques can provide aid in both improving surgical efficiency and potentially reducing surgical morbidity during these complex procedures. The purpose of this narrative review was to explore technical aspects of cement removal for well-fixed implants during rTEA.