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Outcomes After Hemiarthroplasty of the Elbow for the Management of Posttraumatic Arthritis

Minimum 2-Year Follow-up

Werthel, Jean-David, MD; Schoch, Bradley, MD; Adams, Julie, MD; Steinmann, Scott, MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: February 15, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.5435/JAAOS-D-18-00055
Research Article: PDF Only

Background: Hemiarthroplasty (HA) of the elbow represents an alternative to total elbow arthroplasty (TEA) without the associated activity restrictions. This study reviews our experience with distal humerus HA with minimum 2-year follow-up.

Methods: Between 2002 and 2012, 16 elbows underwent HA for posttraumatic arthritis of the elbow. Patients were followed for a minimum of 2 years or until revision surgery. Outcome measures included pre- and postoperative Mayo Elbow Performance Scores (MEPSs), complications, and revisions.

Results: Mean age at arthroplasty was 45 years, and follow-up averaged 51 months. All patients had previously undergone one or more surgical procedures at the elbow (average of 1.5 procedures). At follow-up, five had undergone additional surgery; two were revised to TEA. In surviving implants, the range of motion at follow-up was markedly improved from preoperative motion. The MEPS for the remaining HA included five excellent results, three good results, five fair results, and one poor result.

Discussion: Elbow HA is an option for young or active patients with end-stage elbow posttraumatic arthritis who are unwilling to accept activity limitations. However, high rates of revision surgery and revision to TEA occur after HA for posttraumatic osteoarthritis of the elbow. Only 57% of patients with surviving implants had a good to excellent MEPS, although improvement in the range of motion was predictable.

From the Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.

Correspondence to Dr. Steinmann:

Dr. Schoch or an immediate family member is a member of a speakers' bureau or has made paid presentations on behalf of DJO Global: Medical Devices & Services. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Werthel, Dr. Adams, and Dr. Steinmann.

Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

Procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 and 2008. Informed consent for research purposes was obtained per institutional protocol.

© 2019 by American Academy of Orthopaedic Surgeons
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