Clinical and radiological outcomes of primary semi-constrained total elbow arthroplasty at 10-year mean follow-up.

BACKGROUND

This study aimed to evaluate the long-term clinical and radiological outcomes in patients undergoing semi-constrained total elbow arthroplasty (TEA). Postoperative complications and implant survival rates were also investigated.

METHODS

Of 68 patients who underwent primary semi-constrained TEA, data from 62 with a minimum follow-up of 5 years were analyzed. The mean follow-up duration was 117.1 months (range, 60-246 months). Forty-one patients had posttraumatic conditions, 11 had rheumatoid arthritis, and 10 had osteoarthritis. Clinical outcomes were assessed using the Mayo Elbow Performance Score (MEPS) and Oxford Elbow Score (OES), whereas radiological outcomes were analyzed using radiolucent lines and bushing wear. Kaplan-Meier survival analysis was used to determine the implant survival rate.

RESULTS

At the final follow-up, the MEPS and OES were 88.2 (range, 55-100) and 31.6 (range, 22-42), respectively. Radiolucency of type 3 or 4 was observed on the humeral side in four patients and on the ulnar side in three patients. Grade 1 and 2 bushing wear was present in seven and three patients, respectively. The total complication rate was 25.8% (16/62), and the reoperation rate was 17.7% (11/62). Four patients underwent reoperation for periprosthetic infection after previous open reduction and internal fixation for acute fractures. In addition, three patients underwent hinge system change for hinge dissociation, four sustained periprosthetic fractures, one underwent revision TEA for gross loosening, and one underwent open repair for triceps rupture. Kaplan-Meier survival analysis revealed that the 5-, 10-, and 15-year survival rates of the implants were 100%, 92.8%, and 77.5%, respectively.

CONCLUSIONS

Clinical and radiological outcomes of primary semi-constrained TEA were reasonably good at a mean 10-year follow-up. Type 3 or 4 radiolucency was observed in seven patients and complete bushing wear in three patients, while the 10-year implant survival rate was 92.8%. Level of evidence: IV.