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Prosthetic replacement of the arthritic elbow
1Department of Orthopaedic Surgery, St. Bartholomew's Hospital, West Smithfield, London, United Kingdom.
Current Opinion in Rheumatology
|May 1, 1993
Summary
Elbow prosthetic surgery shows improving results for severe arthritis, primarily rheumatoid disease. However, long-term data is needed to confirm its clinical effectiveness and address complications like loosening and infection.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Biomaterials Science
Background:
- Severe elbow arthritis, often due to rheumatoid disease, presents significant challenges.
- Current elbow prosthetic surgery shows promising but evolving results.
- Longer-term follow-up and larger patient cohorts are necessary to establish definitive clinical outcomes.
Purpose of the Study:
- To review the current literature on elbow prosthetic surgery for severe arthritis.
- To identify the benefits, risks, and challenges associated with elbow joint replacement.
- To discuss alternative surgical options and revision strategies.
Main Methods:
- Comprehensive literature review of studies on elbow prosthetic replacement.
- Analysis of reported outcomes, complications, and patient demographics.
- Evaluation of surgical techniques and revision procedures.
Main Results:
- Elbow prosthetic surgery demonstrates improving outcomes for severe arthritic conditions, predominantly rheumatoid arthritis.
- Common complications include prosthetic loosening, displacement, infection, and neurologic deficits (ulnar nerve).
- Osteoarthritis is less common, with fenestration arthroplasty as an alternative; revision surgery presents difficulties.
Conclusions:
- Elbow prosthetic replacement is still considered in the experimental stage despite improving results.
- Managing patients with concurrent shoulder involvement requires careful consideration, especially regarding prosthesis loosening.
- Further research on combined elbow and shoulder prosthetics is warranted.