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· DOS Abstracts
Revision total elbow arthroplasty using the linked
Coonrad-Morrey implant.
Hans Viggo Skjeldborg Johannsen, Janne Ovesen
Shoulder and Elbow Unit, Orthopaedic Dept, Aarhus University Hospital
Background:
Total elbow arthroplasty is not a common procedure, and reports
on revision elbow arthroplasty are rare.
Purpose / Aim of Study:
The objective of the present study was to report our
experience with revision elbow arthroplasty using a semiconstrained Coonrad-
Morrey prosthesis and to review the functional outcome after revisions.
Materials and Methods:
From 2000 to 2010, 58 patients (58 elbows) had a
revision elbow arthroplasty using a linked Coonrad-Morrey implant. Forty-five
patients were revised because of aseptic loosening and 13 because of infection.
There were 27 women and 31 men with a mean age 63 (range 35 to 83) years
at the time of revision. Thirteen had died from unrelated causes at a mean of 38
months (range 16 to 61 months) post-operatively, in all except one patient the
implant was in place. Five of the surviving 45 patients were unable to return for
follow-up. Mean follow-up was 5,3 (range 1 to 12) years. Follow-up included
Mayo Elbow Performance Score and Oxford Elbow core, radiographs and clinical
examination.
Findings / Results:
Forty elbows in 40 patients had a full follow-up.The
mean Oxford Elbow score was 26.8 (8 to 48). According to the Mayo Elbow
Performance Score, 31 elbows had a satisfactory outcome (6 excellent, 8 good,
17 fair). The mean score was 70.5 (range 45 to 100). Eight of the 40 patients
had been re-revised; five because of infection and three because of aseptic
loosening. Complications included ulnar nerve palsy, intraoperative fracture, tri-
ceps failure, deep infection and aseptic loosening.
Conclusions:
Revision elbow arthroplasty is a technically challenging procedure
and both the short term and long term complication rates sre high. A number of
different surgical options should be considered and the treatment individualized.
Satisfactory results can be achieved in most cases.There is a high incidence of
progressive radiolucency and patients should be monitored closely.
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