title: Outcome after total elbow arthroplasty: a retrospective study of 167 procedures performed from 1981 to 2008.
abstract: BACKGROUND
  Total elbow arthroplasties (TEAs) are traditionally grouped into linked and unlinked design. The aim was to analyze the difference in clinical outcomes after TEA based on implant design and indication for surgery and to evaluate primary and revision TEAs.
  
  
  METHODS
  A total of 167 TEAs (126 primary and 41 revision TEAs) in 141 patients were evaluated with patient-reported outcome measure by the Oxford Elbow Score (OES) and clinically assessed with the Mayo Elbow Performance Score (MEPS), range of motion (ROM), and standard radiographs.
  
  
  RESULTS
  The mean follow-up was 10.5 years for primary and 7.5 years for revision TEAs. There was no difference in OES or MEPS between linked and unlinked primary TEAs. The OES score in the social-psychological domain was significantly lower in TEAs performed due to fracture (67) compared with rheumatoid arthritis (81; P = .025). ROM in extension-flexion was 116° for primary linked TEAs compared with 110° for primary unlinked TEAs (P = .02). Revision TEAs were associated with a poorer outcome in OES, MEPS, and ROM compared with primary TEAs. Radiographic signs of loosening were seen in 15 primary and 7 revision TEAs at follow-up.
  
  
  CONCLUSIONS
  We found no clinically significant differences in outcomes after linked or unlinked TEAs. Patients with TEAs due to fracture had poorer social-psychological results than rheumatoid arthritis patients. The results after revision surgery were significantly inferior compared with primary procedures. The OES contributes to the evaluations of the outcome after TEA surgery with a nuanced picture of the patient's perception.
authors.affiliation: Shoulder and Elbow Clinic, Department of Orthopedic Surgery, Herlev, Copenhagen University Hospital, Herlev, Denmark. Electronic address: hcplaschke@dadlnet.dk.
authors.forename: Hans Christian
authors.initials: HC
authors.lastname: Plaschke
authors.affiliation: Shoulder and Elbow Clinic, Department of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Theis M
authors.initials: TM
authors.lastname: Thillemann
authors.affiliation: Shoulder and Elbow Clinic, Department of Orthopedic Surgery, Herlev, Copenhagen University Hospital, Herlev, Denmark.
authors.forename: Stig
authors.initials: S
authors.lastname: Brorson
authors.affiliation: Shoulder and Elbow Clinic, Department of Orthopedic Surgery, Herlev, Copenhagen University Hospital, Herlev, Denmark.
authors.forename: Bo S
authors.initials: BS
authors.lastname: Olsen
mesh_terms: D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000601:surgery*; D057929:Arthroplasty, Replacement, Elbow / Q000379:methods*; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Total elbow arthroplasty; elbow surgery; patient-related outcome measure; prosthesis; reconstructive surgery; revision arthroplasty; rheumatoid arthritis