Total elbow arthroplasty.
The results of 36 total elbow arthroplasties in 32 patients are presented. The follow-up period ranged from 3 to 12 years. The preoperative diagnosis was rheumatoid arthritis in 27 patients and posttraumatic degenerative joint disease in 5. There were 23 women and 9 men. Unconstrained prostheses (London) were implanted in 6 elbows, semiconstrained prostheses (MAYO, AMC, and triaxial) in 26, and constrained prostheses (GSB, Schlein) were used in 4. There were five perioperative fractures (14%) that were successfully treated nonoperatively. Three ulnar nerve neuropraxias occurred (8%), one of which required surgical exploration and repeat anterior transfer of the nerve. Two superficial postoperative infections (6%) responded to nonoperative treatment. Major complications necessitating revision surgery occurred in 18 (50%). Loosening of the prostheses occurred in nine (25%); two were treated by reimplantation, with prosthetic removal in the others. Deep infections in four (11%) and dislocations occurring in two (6%) necessitated prosthetic removal. Traumatic fractures occurred in two (6%); one was successfully treated by internal fixation, while the other failed internal fixation, requiring prosthetic removal. Radiolucent lines were seen in 20 (56%).