Revision of total elbow replacement by exchange cementing.
We report the effectiveness of revision of total elbow replacement by re-cementing. Between 1982 and 2004, 53 elbows in 52 patients were treated with re-cementing of a total elbow replacement into part or all of the existing cement mantle or into the debrided host-bone interface, without the use of structural bone augmentation or a custom prosthesis. The original implant revision was still in situ and functional in 42 of 53 elbows (79%) at a mean of 94.5 months (26 to 266) after surgery. In 31 of these 42 elbows (74%) the Mayo Elbow Performance Score was good or excellent. Overall, of the 53 elbows, 18 (34%) required re-operation, ten (19%) for loosening. A classification system was developed to identify those not suitable for revision by this technique, and using this we have showed that successful re-implantation is statistically correlated to properly addressing the bone deficiency for both the humeral (p = 0.005) and the ulnar (p = 0.039) components.
University of Otago, Department of Orthopaedics and Musculoskeletal Medicine, 2 Riccarton Avenue, Christchurch 8140, New Zealand.
A A
AA
Malone
J S
JS
Sanchez
R
R
Adams
B
B
Morrey
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057929:Arthroplasty, Replacement, Elbow / Q000009:adverse effects / Q000379:methods*; D002484:Cementation / Q000009:adverse effects / Q000379:methods*; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome