TOTAL ELBOW ARTHROPLASTY - REVISION WITH USE OF A NON-CUSTOM SEMICONSTRAINED PROSTHESIS

The results of revision elbow arthroplasty with use of the semiconstra ined Mayo-modified Coonrad implant in forty-one patients were reviewed retrospectively. The average duration of follow-up was six years (ran ge, two to thirteen years). At the time of the latest follow-up evalua tion, thirty-eight patients were able to perform activities of daily l iving, one had a stiff elbow because of heterotopic ossification, one had weakness secondary to an injury of the radial nerve, and one had a n unstable elbow after removal of the prosthesis because of recurrent aseptic loosening. Fourteen patients sustained either a fracture or a perforation of the cortex at the time of removal of the primary implan t. Three of these patients had an injury of the radial nerve; the inju ry was due to extravasation of the cement from a cortical defect in tw o of them and was sustained during removal of the cement in one. Eight patients had an intraoperative or postoperative complication that nec essitated additional operative intervention. Postoperatively, twenty-t wo patients had complete relief of pain and sixteen had mild discomfor t. Three patients remained disabled; one, because of pain secondary to loosening of the component; one, because of a pre-existing nerve inju ry; and one, because of the residual effect of an intraoperative injur y of the radial nerve. The average Mayo elbow performance score was 87 +/- 16 points at the latest follow-up evaluation, compared with 44 +/ - 17 points preoperatively (p < 0.0001). Revision elbow arthroplasty r estored function to the patients who had had a failed prosthesis witho ut infection.