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. 2025 Jul;17(3):332-340.
doi: 10.1177/17585732241246756. Epub 2024 Apr 16.

The age specific performance of elbow hemiarthroplasty: A systematic review

John J Heifner  1 , Peter A Falgiano  1 , Thomas O Yergler  2 , Ty A Davis  2 , Nathan A Hoekzema  3 , Jorge L Orbay  2
Affiliations

The age specific performance of elbow hemiarthroplasty: A systematic review

John J Heifner et al. Shoulder Elbow. 2025 Jul.

Abstract

Background: Compared to total elbow arthroplasty, elbow hemiarthroplasty (EHA) does not have an ulnar component or a hinge/link which eliminates complication risk due to polyethylene wear and ulnar loosening. There are notable gaps in the existing EHA literature. Patient age is often identified as an important determinant when deciding to treat with EHA; however, there is limited age-based evidence. Our systematic review objectives were (a) to compare EHA outcomes between younger and older adults, and (b) to stratify outcomes for EHA by prosthesis.

Methods: In compliance with PRISMA guidelines, databases were searched for EHA studies and 65 years was used to delineate younger and older adults.

Results: Older adults (N = 159) had a significantly higher elbow arc of motion compared to younger adults (N = 121) at a mean follow-up of 51 months. There was a significantly increased risk for a MEPS below 75 in younger compared to older adults. Mean Disabilities of the Arm, Shoulder, and Hand scores and rates of revision/removal were comparable between age groups.

Conclusion: The current findings suggest that although elbow range of motion may be limited in younger adults following EHA, function is satisfactory and comparable to the function in older adults. Additionally, the risk of revision/removal surgery is similar between younger and older adults across short to mid-terms of follow-up.

Keywords: distal humerus fracture; elbow arthritis; elbow hemiarthroplasty; elbow replacement.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart summarizing the database search return, assessment, and final selection including specific exclusion criteria.
Figure 2.
Figure 2.
Graphical distribution of categorical results for the Mayo Elbow performance score.
See this image and copyright information in PMC

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