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. 2017 Jul;5(7):e4.
doi: 10.2106/JBJS.RVW.16.00089.

Total Elbow Arthroplasty: A Systematic Review

Chantal L Welsink  1 , Kaj T A Lambers  2 , Derek F P van Deurzen  1 , Denise Eygendaal  2   3 , Michel P J van den Bekerom  1
Affiliations

Total Elbow Arthroplasty: A Systematic Review

Chantal L Welsink et al. JBJS Rev. 2017 Jul.

Abstract

Background: Most total elbow arthroplasty (TEA) designs aim to replicate anatomy and provide stability in the treatment of the degenerative elbow joint. Given the promising results that have been reported following the use of TEA for the treatment of complex fractures, the indications for this procedure are growing. The objective of the present study was to review the most recent literature on the results of the most commonly performed TEAs.

Methods: A comprehensive literature search was conducted. All relevant studies were reviewed according to a set of predefined inclusion and exclusion criteria. After the initial assessment, 2 authors extracted data from the included articles. Groups were created on the basis of the design of TEA implant, the type of implant (linked or unlinked), and the indication for treatment. Outcome parameters were survival rate, pain, range of motion, complications, and specific elbow outcome scores.

Results: Seventy-three articles involving a total of 9,379 TEAs were included. The level of evidence was primarily Level IV. Nineteen specific designs of TEA implants were described, including the Souter-Strathclyde (n = 2,387), Coonrad-Morrey (n = 1,586), Kudo (n = 560), and GSB III (n = 498). The most common indication for TEA was rheumatoid arthritis (70%). The weighted mean survival rate for the linked and unlinked prostheses was 85.5% at 7.8 years and 74% at 12.3 years, respectively. For the Coonrad-Morrey, Souter-Strathclyde, and GSB III, the weighted mean survival rate was 87.2% at 7.2 years, 70.6% at 14.2 years, and 81.7% at 9.5 years, respectively. The range of motion after TEA was good overall, with a mean flexion angle of 129° and a mean extension lag angle of 30°. The complication rates ranged from 11% to 38%, with clinical loosening being the most frequently reported complication (7%).

Conclusions: The results of TEA are respectable overall. It appears that there are small differences between designs. However, despite the fairly good functional results and elbow scores, the survival and complication rates are still not as favorable as those following arthroplasties in other joints.

Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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References

    1. Prkić A, van Bergen CJ, The B, Eygendaal D. Total elbow arthroplasty is moving forward: Review on past, present and future. World J Orthop. 2016 Jan 18;7(1):44-9.
    1. Voloshin I, Schippert DW, Kakar S, Kaye EK, Morrey BF. Complications of total elbow replacement: a systematic review. J Shoulder Elbow Surg. 2011 Jan;20(1):158-68.
    1. Park SE, Kim JY, Cho SW, Rhee SK, Kwon SY. Complications and revision rate compared by type of total elbow arthroplasty. J Shoulder Elbow Surg. 2013 Aug;22(8):1121-7. Epub 2013 May 08.
    1. Prasad N, Dent C. Outcome of total elbow replacement for distal humeral fractures in the elderly: a comparison of primary surgery and surgery after failed internal fixation or conservative treatment. J Bone Joint Surg Br. 2008 Mar;90(3):343-8.
    1. Prasad N, Dent C. Outcome of total elbow replacement for rheumatoid arthritis: single surgeon’s series with Souter-Strathclyde and Coonrad-Morrey prosthesis. J Shoulder Elbow Surg. 2010 Apr;19(3):376-83. Epub 2010 Jan 13.

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