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Orthop Traumatol Surg Res. 2014 Feb;100(1):113-8. doi: 10.1016/j.otsr.2013.10.012. Epub 2013 Dec 24.

Is total elbow arthroplasty indicated in the treatment of traumatic sequelae? 19 cases of Coonrad-Morrey(®) reviewed at a mean follow-up of 5.2 years.

Author information

1
Service de chirurgie plastique et reconstructrice de l'appareil locomoteur, Centre chirurgical Emile-Gallé, CHU de Nancy, 54000 Nancy, France. Electronic address: pybarthel@gmail.com.
2
Service de Chirurgie orthopédique et traumatologique, CHU Purpan, 31000 Toulouse, France.
3
Service de chirurgie orthopédique et traumatologique, Centre chirurgical Emile-Gallé, 54000 Nancy, France.
4
Service de chirurgie plastique et reconstructrice de l'appareil locomoteur, Centre chirurgical Emile-Gallé, CHU de Nancy, 54000 Nancy, France.

Abstract

INTRODUCTION:

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 60 years old (56 in group 1 and 67 in group 2). The mean delay between the initial trauma and arthroplasty was 16 years (group 1) and 22 months (group 2).

RESULTS:

At a mean follow-up of 5.5 years (24-156 months) 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 4.6 years (24-108 months) 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%).

CONCLUSION:

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.

KEYWORDS:

Arthroplasty; Elbow; Non-union; Osteoarthritis; Trauma

PMID:
24370486
DOI:
10.1016/j.otsr.2013.10.012
[Indexed for MEDLINE]
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