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Complications of total elbow arthroplasty
Clinical Orthopaedics and Related Research
|October 1, 1982
Summary
Revision elbow surgery rates vary by prosthesis type, with semiconstrained designs showing lower loosening risks. Careful surgical technique minimizes complications like infection and nerve issues, emphasizing surgeon experience for optimal outcomes.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Reconstructive Surgery
Background:
- Revision surgery for loosening is common with tightly constrained elbow prostheses.
- Semiconstrained designs and resurfacing prostheses present different stability and complication profiles.
- Infection rates are significant, necessitating effective salvage procedures like resection arthroplasty.
Purpose of the Study:
- To analyze complication rates and outcomes associated with various elbow replacement prostheses.
- To evaluate the impact of surgical techniques on revision rates and functional results.
- To highlight potential pitfalls and best practices in elbow arthroplasty.
Main Methods:
- Review of complication data associated with different elbow prosthesis designs.
- Analysis of surgical techniques, including triceps-sparing approaches and nerve translocation.
- Assessment of outcomes for infection, implant failure, and neurological complications.
Main Results:
- Loosening rates exceed 25% for tightly constrained prostheses, significantly lower for semiconstrained types.
- Infection rates range from 4% to 9%, with resection arthroplasty as a viable salvage option.
- Triceps insufficiency is minimized with specific triceps-sparing approaches; ulnar nerve dysfunction occurs in approximately 10%.
Conclusions:
- Elbow arthroplasty outcomes are influenced by prosthesis design and surgical technique.
- Careful patient selection and experienced surgical execution are crucial for minimizing complications.
- Ongoing refinement of surgical methods is improving safety and efficacy in elbow replacement.