PRIMARY SEMICONSTRAINED TOTAL ELBOW ARTHROPLASTY - SURVIVAL ANALYSIS OF 113 CONSECUTIVE CASES

We used survival analysis to evaluate 113 consecutive semiconstrained total elbow arthroplasties (TEAs) in 95 patients at a maximum follow-u p of 99 months. Our criteria for failure were mechanical malfunction, revision for any reason, and deep infection. The primary diagnosis was inflammatory arthritis in 86 elbows, post-traumatic arthritis in 6, s upracondylar nonunion or fracture in 12, osteoarthritis in 2 and other causes in 3. Seven failures were due to deep infection, and five of t hese had a primary diagnosis of inflammatory arthritis. Eight failures were revised or had revision recommended for aseptic loosening, and s ix of these were in patients with post-traumatic arthritis or supracon dylar nonunion. The cumulative survival for TEAs performed for post-tr aumatic arthritis, fractures or supracondylar nonunion was 73% at thre e years and 53% at five years, significantly worse than the cumulative three- and five-year survivals of 92% and 90%, respectively, for pati ents with inflammatory arthritis. TEA with a semiconstrained prosthesi s appears to have a satisfactory survival in selected patients with ar thritic disorders. The incidence of deep infection was reduced by impr ovements in surgical technique and postoperative management, and the r outine use of antibiotic-impregnated cement. The incidence of aseptic loosening was low, except in patients with supracondylar nonunion or p ost-traumatic arthritis.