Traumatic sequelae of the elbow are difficult to manage because of bone deformities, changes in joint congruency and bone defects.
Materials and methods
Total elbow arthroplasty is a therapeutic option when the joint space has disappeared. Nineteen patients underwent semi-constrained Coonrad-Morrey® total elbow arthroplasty in 12 cases for post-traumatic elbow arthritis (group 1) and in seven cases for 7 non-union of the distal humerus (group 2). The mean age at surgery was 60years old (56 in group 1 and 67 in group 2). The mean delay between the initial trauma and arthroplasty was 16years (group 1) and 22months (group 2).
At a mean follow-up of 5.5years (24–156months) in group 1, the Quick-DASH score was 34 points with outcomes that were considered to be good to excellent in 75% of the cases according to the Mayo Elbow Performance Score (MEPS). A progressive radiolucency was identified on X-ray in 33% of the cases, and moderate wear of the polyethylene insert in 17%. There were 7 complications (58%) requiring revision in 3 cases (25%). At a mean follow-up of 4.6years (24–108months) in group 2, the Quick-DASH score was 39 points with good and excellent results in 86% according to the MEPS. A radiolucency was noted in 28% and moderate wear of the inserts in 14%. There were 2 complications (28%) requiring revision in 1 case (14%).
Semi-constrained total elbow arthroplasties provide recovery of functional range of motion with a stable and pain-free elbow for post-traumatic conditions. The age at surgery is a risk factor for complications. The indication for total elbow arthroplasty in patients under 60 should be carefully considered in relation to alternative treatment options.
Level of evidence
Level IV Retrospective study.Le texte complet de cet article est disponible en PDF.
Keywords : Elbow, Arthroplasty, Trauma, Osteoarthritis, Non-union