title: Clinical and radiographic outcome of revision surgery of total elbow prosthesis: midterm results in 19 cases.
abstract: BACKGROUND
  The aim of this study is to report on the midterm outcomes and complications of revision surgery of total elbow arthroplasty.
  
  
  METHODS
  All patients who had undergone total elbow arthroplasty revision surgery between 2009 and 2014 with semiconstrained total elbow prostheses were prospectively enrolled in the study. Records were reviewed for demographic data; baseline measurements; and several follow-up assessments including the Mayo Elbow Performance Score (MEPS), visual analog scale (VAS) score for pain, Oxford Elbow Score, range of motion, satisfaction, and radiographs.
  
  
  RESULTS
  A total of 19 revision arthroplasties were included. At a mean follow-up of 57 months, there had been 1 rerevision and 2 removals. One patient was excluded from follow-up because of confounding comorbidity. At last follow-up, MEPS values and VAS pain scores both improved (P < .01). The rate of combined good and excellent results on the MEPS was 53%. The mean VAS scores for pain at rest and with activity were 2 and 4, respectively. Fair results for the Oxford Elbow Score were reported, with a mean score of 28 points. Range of motion improved to an average flexion-extension arc of 108° (P < .01), and the pronation-supination arc improved to an average of 123° (P < .01). All elbows were stable at last follow-up (P < .01). Radiographs showed nonprogressive osteolysis around the prosthesis in 3 cases (19%) and suspicion of loosening in 1 (6%). In 11 patients postoperative complications occurred. Of 15 patients, 13 (87%) were satisfied with the result of the revision procedure.
  
  
  CONCLUSIONS
  Revision of total elbow prostheses leads to satisfactory results, less pain, and better elbow function. This procedure is related to a relatively high complication rate.
authors.affiliation: Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands. Electronic address: jetskeviveen@gmail.com.
authors.forename: Jetske
authors.initials: J
authors.lastname: Viveen
authors.affiliation: Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Ante
authors.initials: A
authors.lastname: Prkic
authors.affiliation: Foundation for Orthopedic Research, Care & Education, Amphia Hospital, Breda, The Netherlands.
authors.forename: Koen L M
authors.initials: KL
authors.lastname: Koenraadt
authors.affiliation: Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands; Department of Orthopaedic Surgery, University of Amsterdam, Amsterdam-Zuidoost, The Netherlands.
authors.forename: Izaäk F
authors.initials: IF
authors.lastname: Kodde
authors.affiliation: Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Bertram
authors.initials: B
authors.lastname: The
authors.affiliation: Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands; Department of Orthopaedic Surgery, University of Amsterdam, Amsterdam-Zuidoost, The Netherlands.
authors.forename: Denise
authors.initials: D
authors.lastname: Eygendaal
mesh_terms: D000368:Aged; D057929:Arthroplasty, Replacement, Elbow / Q000009:adverse effects; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D058569:Elbow Prosthesis / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000209:etiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011403:Pronation; D011475:Prosthesis Failure / Q000209:etiology; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation / Q000009:adverse effects; D013484:Supination; D013997:Time Factors; D016896:Treatment Outcome
keywords: Elbow; complications; outcome; prosthesis; revision; total elbow arthroplasty