Clinical outcomes and complications following primary total elbow arthroplasty using the Latitude prosthesis

Abstract

Background: The Latitude total elbow arthroplasty (TEA) is an implant with limited published data on its performance and outcomes. The aim of this study was to report the short-term outcomes of the Latitude TEA as well as to describe the radiographic outcomes and complications.

Methods: The Latitude was implanted in 20 patients (23 elbows) in a linked configuration. Patients were recalled to clinic for the assessment of their range-of-motion and compared to preoperative values. Administration of functional outcome measures was also performed.

Results: Mean follow-up was 4.7 years (range, 1 to 7.5 years) with four elbows requiring revision. The flexion-extension arc improved from 86.6 to 101.3 (range, 76 to 126) postoperatively (p = 0.04). The average Disabilities of the Arm, Shoulder, and Hand score was 28.1 (range, 5.8 to 50.4) and the average Mayo Elbow Performance Score was 89.6 (range, 76 to 100), with 83% of elbows scoring in the good or excellent range. Radiolucencies were detected in 60% of patients and 31% of these lucencies progressed in size at the time of follow-up.

Conclusions: The Latitude prosthesis provides patients with favorable clinical outcomes with improvements in their range-of-motion and a complication rate comparable to other elbow arthroplasty implants.

Keywords: Latitude; Total elbow arthroplasty; arthroplasty complications; elbow arthritis; radial head dissociation; rheumatoid arthritis.

Figure 1.

Summary of the number of patients and elbows contributing to the various outcome measures.

Figure 2.

Radial head component dislocation (white arrow) at one-month postoperative in a patient who underwent a Latitude total elbow arthroplasty. Anteroposterior (a) and lateral (b) radiographs of the elbow. There is also evidence of cement extrusion (dashed white arrow) from a breach in the ulnar cortex with residual cement surrounding the forearm.

Figure 3.

Humeral spool set screw back-out (white arrow) identified incidentally on routine follow-up radiographs. The patient was asymptomatic and was observed.

Figure 4.

Non-progressive and progressive radiolucencies of the humeral and ulnar components of the Latitude total elbow arthroplasty at four years postoperative. Evidence of a non-progressive lucency (solid white arrow) posterior to the humeral component at the two week postoperative point (a) with no evidence of progression at four years postoperative (b). The dashed white arrow indicates development of a progressive lucency at the tip of the ulnar component (b) which was not present immediately postoperative (a).