Sustained functionality and survivorship of the Coonrad-Morrey linked elbow prosthesis is replicated by an Asian institution with evolving indications over 18 years
The purpose of this study is to assess the changing indications, survivorship, and functional outcomes of patients who underwent a semi-constrained total elbow arthroplasty (TEA) of a homogenous design at an Asian institution. Retrospective analysis of 47 patients (47 elbows) who underwent TEA from...
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| Published in: | Seminars in arthroplasty Vol. 32; no. 4; pp. 780 - 786 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Elsevier Inc
01-12-2022
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | The purpose of this study is to assess the changing indications, survivorship, and functional outcomes of patients who underwent a semi-constrained total elbow arthroplasty (TEA) of a homogenous design at an Asian institution.
Retrospective analysis of 47 patients (47 elbows) who underwent TEA from January 1998 to December 2016 was performed. Demographic data, baseline comorbidities as defined by the Charlson Comorbidity Index, indication for surgery, preoperative and postoperative range of motion, radiographic analysis, complications, and need for revisions were collected. Kaplan-Meier survivorship analysis was performed.
Of the 47 patients, none were lost to follow-up. The mean duration of follow-up was 127 months. There was a total of 13 male patients and 34 female patients with a mean age at the time of implantation of 65.4 years (range 24-92). The final arc of motion had a mean flexion of 115.8° and a mean extension of 14.8°. The functional range of motion of the elbow improved from 58.8° ± 38.2° preoperatively to 106.6° ± 20.3° postoperative (P < .001). From 1998 to 2004, 39.1% of TEAs were associated with trauma and another 39.1% with rheumatoid arthritis. From 2010 to 2016, 66.7% of TEAs were performed for trauma and only 20% were performed for rheumatoid arthritis. All our patients had either the extra small or the small-sized Coonrad-Morrey TEA prosthesis implanted with 21.1% of patients with the ulna stem ending before the proximal ulna dorsal angulation. There was a total of 11 complications with revision surgery required for 2 periprosthetic fractures, 1 humeral loosening, and 1 linkage disassembly. The overall survivorship for TEA at our institution was 91.5%.
Our results reflect that good outcomes and robust survivorship to that experienced in the United States are demonstrated despite the changing indications of TEA. Current trends of usage demand continued development of linked elbow prosthesis with smaller sizing options. |
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| ISSN: | 1045-4527 1558-4437 |
| DOI: | 10.1053/j.sart.2022.06.002 |