title: Total elbow arthroplasty: a radiographic outcome study.
abstract: OBJECTIVE
  Total elbow arthroplasty (TEA) is becoming a popular alternative to arthrodesis for patients with end-stage elbow arthrosis and comminuted distal humeral fractures. Prior outcome studies have primarily focused on surgical findings. Our purpose is to determine the radiographic outcome of TEA and to correlate with clinical symptoms such as pain.
  
  
  METHODS
  This is an IRB-approved retrospective review from 2005 to 2015 of all patients with semiconstrained TEA. All available elbow radiographs and clinical data were reviewed. Data analysis included descriptive statistics and Kaplan-Meier survival curves for radiographic and clinical survival.
  
  
  RESULTS
  A total of 104 total elbow arthroplasties in 102 patients were reviewed; 75 % were in women and the mean patient age was 63.1 years. Mean radiographic follow-up was 826 days with average of four radiographs per patient. Seventy TEAs (67 %) developed radiographic complications, including heterotopic ossification (48 %), perihardware lucency (27 %), periprosthetic fracture (23 %), hardware subluxation/dislocation (7 %), polyethylene wear (3 %), and hardware fracture/dislodgement (3 %); 56 patients (55 %) developed symptoms of elbow pain or instability and 30 patients (30 %) underwent at least one reoperation. In patients with radiographic complications, 66 % developed elbow pain, compared to 19 % of patients with no radiologic complications (p = 0.001). Of the patients with radiographic complications, 39 % had at least one additional surgery compared to 0 % of patients without radiographic complications (p = 0.056).
  
  
  CONCLUSIONS
  Radiographic complications are common in patients after total elbow arthroplasty. There is a strong positive association between post-operative radiographic findings and clinical outcome. Knowledge of common postoperative radiographic findings is important for the practicing radiologist.
authors.affiliation: Department of Radiology, University of Washington, Box 357115, 1959 N.E. Pacific Street, Seattle, WA, 98195, USA.
authors.forename: Xue Susan
authors.initials: XS
authors.lastname: Bai
authors.affiliation: Department of Radiology, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
authors.forename: Jonelle M
authors.initials: JM
authors.lastname: Petscavage-Thomas
authors.affiliation: Department of Radiology, University of Washington, Box 354755, 4245 Roosevelt Way NE, Seattle, WA, 98105, USA. aha1@uw.edu.
authors.forename: Alice S
authors.initials: AS
authors.lastname: Ha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057929:Arthroplasty, Replacement, Elbow / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data*; D058569:Elbow Prosthesis / Q000592:standards*; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011474:Prosthesis Design; D017755:Prosthesis Fitting / Q000379:methods*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014861:Washington / Q000453:epidemiology
keywords: Arthroplasty; Elbow; Hardware; Joint replacement; Radiography