Complications and revisions after semi-constrained total elbow arthroplasty: a mono-centre analysis of one hundred cases.

BACKGROUND

The complication rate after total elbow arthroplasties is higher than for other arthroplasties.

PURPOSE

The purpose of this study was to evaluate the complications and revision rate after 100 semi-constrained total elbow arthroplasties from various types of aetiologies performed in our university hospital.

METHODS

One hundred linked semiconstrained total elbow arthroplasties were performed and were reviewed with 24-months minimum follow-up. Indications were rheumatoid arthritis (45), trauma (33), revisions (16) and others (6).

RESULTS

At five years average follow-up (range, 2-11), the complication rate was 37 %. Most frequent complications were ulnar nerve involvement (9 %) and triceps insufficiency (7 %). Five implants were aseptically loosed. The infection rate was 4 % with loosening of the implant in two. Four fractures were observed, including three at the ulna and one at the humerus proximal or distal to the stem. The radial nerve was injured in two cases. Failure of the locking system of the prosthesis was noted in one case and a fracture of the ulnar component was found in another patient. A revision surgery was performed in 13 cases (13 %). At follow-up 94 prostheses were still in place and the survival rate was 98 % at five years and 86 % at ten years.

CONCLUSION

Total elbow arthroplasty remains a difficult procedure with sometimes a high rate of complications necessitating revision procedures. Selection of the patients, a rigorous surgical technique, and a systematic follow-up are prerequisite to limit this incidence.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.