Abstract
Purpose
In this retrospective study we evaluated the short- to medium-term results after 20 Coonrad-Morrey revision total elbow arthroplasties (TEAs).
Methods
We included a consecutive series of revision TEAs performed at our institution from 2004 to 2010. At a mean follow-up of 4.4Â years, patients were evaluated using the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES) and standard radiographs.
Results
The mean age at revision TEA was 65.8Â years. The median time of implant survival for primary prosthesis was 9.5Â years. The mean post-operative MEPS was 79. The mean OES was 58, 66 and 53 for function, pain and social-psychological dimensions, respectively. At follow-up the range of motion had improved significantly. There were two cases of radiolucent lines and two cases of minor bushing wear; however, none of the implants were clinically loose. In one case deep infection led to a further revision. Two patients had post-operative ulnar nerve paraesthesia.
Conclusions
Results after revision TEA using the Coonrad-Morrey prosthesis are acceptable with a low short- to midterm failure rate. Revision improves range of motion and provides pain relief. One case of deep infection with recurrent revision is of concern. The treatment can be used as an option for failed TEA.
Similar content being viewed by others
References
Schmidt K, Hilker A, Miehlke RK (2007) Differences in elbow replacement in rheumatoid arthritis. Orthopade 36(8):714–722
King GJ, Adams RA, Morrey BF (1997) Total elbow arthroplasty: revision with use of a non-custom semiconstrained prosthesis. J Bone Joint Surg Am 79(3):394–400
Levy JC, Loeb M, Chuinard C, Adams RA, Morrey BF (2009) Effectiveness of revision following linked versus unlinked total elbow arthroplasty. J Shoulder Elbow Surg 18(3):457–462. doi:10.1016/j.jse.2008.11.016
Schneeberger AG, Meyer DC, Yian EH (2007) Coonrad-Morrey total elbow replacement for primary and revision surgery: a 2- to 7.5-year follow-up study. J Shoulder Elbow Surg 16(3 Suppl):S47–S54. doi:10.1016/j.jse.2006.01.013
Shi LL, Zurakowski D, Jones DG, Koris MJ, Thornhill TS (2007) Semiconstrained primary and revision total elbow arthroplasty with use of the Coonrad-Morrey prosthesis. J Bone Joint Surg Am 89(7):1467–1475. doi:10.2106/JBJS.F.00715
Sneftrup SB, Jensen SL, Johannsen HV, Søjbjerg JO (2006) Revision of failed total elbow arthroplasty with use of a linked implant. J Bone Joint Surg Br 88(1):78–83. doi:10.1302/0301-620x.88B1.16446
Athwal GS, Morrey BF (2006) Revision total elbow arthroplasty for prosthetic fractures. J Bone Joint Surg Am 88:2017–2026
Sanchez-Sotelo J (2011) Total elbow arthroplasty. Open Orthop J 5:115–123. doi:10.2174/1874325001105010115(9):2017-26.doi:10.2106/JBJS.E.00878
Futai K, Tomita T, Yamazaki T et al (2010) In vivo three-dimensional kinematics of total elbow arthroplasty using fluoroscopic imaging. Int Orthop 34(6):847–854. doi:10.1007/s00264-010-0972-1
Fevang BT, Lie SA, Havelin LI, Skredderstuen A, Furnes O (2009) Results after 562 total elbow replacements: a report from the Norwegian Arthroplasty Register. J Shoulder Elbow Surg 18(3):449–456. doi:10.1016/j.jse.2009.02.020
Skyttä ET, Eskelinen A, Paavolainen P, Ikävalko M, Remes V (2009) Total elbow arthroplasty in rheumatoid arthritis: a population-based study from the Finnish Arthroplasty register. Acta Orthop 80(4):472–477. doi:10.3109/17453670903110642
Bernardino S (2010) Total elbow arthroplasty: history, current concepts, and future. Clin Rheumatol 29(11):1217–1221. doi:10.1007/s10067-010-1539-7
Celli A, Morrey BF (2009) Total elbow arthroplasty in patients forty years of age or less. J Bone Joint Surg Am 91(6):1414–1418. doi:10.2106/JBJS.G.00329
Voloshin I, Schippert DW, Kakar S, Kaye EK, Morrey BF (2011) Complications of total elbow replacement: a systematic review. J Shoulder Elbow Surg 20(1):158–168. doi:10.1016/j.jse
Morrey BF, Adams RA (1992) Semiconstrained arthroplasty for the treatment of rheumatoid arthritis of the elbow. J Bone Joint Surg Am 74(4):479–490
Dawson J, Doll H, Boller I, Fitzpatrick R, Little C, Rees J et al (2008) Comparative responsiveness and minimal change for the Oxford Elbow Score following surgery. Qual Life Res 17(10):1257–1267. doi:10.1017/s11136-008-9409
Dawson J, Doll H, Boller I, Fitzpatrick R, Little C, Rees J et al (2008) The development and validation of a patient-reported questionnaire to assess outcomes of elbow surgery. J Bone Joint Surg Br 90(4):466–473. doi:10.1302/0301-620x.90B4.20290
Beaton DE, Bombardier C, Guillemin F, Ferraz MB (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976) 25(24):3186–3191
Souter WA (1973) Arthroplasty of the elbow with particular reference to metallic hinge arthroplasty in rheumatoid patients. Orthop Clin North Am 4(2):395–413
Souter WA (1990) Surgery of the rheumatoid elbow. Ann Rheum Dis 49(Suppl 2):871–882
Kamme C, Lindberg L (1981) Aerobic and anaerobic bacteria in deep infections after total hip arthroplasty: differential diagnosis between infectious and non-infectious loosening. Clin Orthop Relat Res 154:201–207
Little CP, Graham AJ, Carr AJ (2005) Total elbow arthroplasty: a systematic review of the literature in the English language until the end of 2003. J Bone Joint Surg Br 87(4):437–444. doi:10.1302/0301-620X.87B4.15692
Yamaguchi K, Adams RA, Morrey BF (1998) Infection after total elbow arthroplasty. J Bone Joint Surg Am 80(4):481–491
Vergidis P, Greenwood-Quaintance KE, Sanchez-Sotelo J, Morrey BF, Steinmann SP, Karau MJ et al (2011) Implant sonication for the diagnosis of prosthetic elbow infection. J Shoulder Elbow Surg 20(8):1275–1281. doi:10.1016/j.jse.2011.06.016
Ring D, Kocher M, Koris M, Thornhill TS (2005) Revision of unstable capitellocondylar (unlinked) total elbow replacement. J Bone Joint Surg Am 87(5):1075–1079. doi:10.2106/JBJS.D02449
van der Lugt JC, Rozing PM (2006) Outcome of revision surgery for failed primary Souter-Strathclyde total elbow prosthesis. J Shoulder Elbow Surg 15:208–214. doi:10.1016/j.jse.2005.07.009
Redfern DR, Dunkley AB, Trail IA, Stanley JK (2001) Revision total elbow replacement using the Souter-Strathclyde prosthesis. J Bone Joint Surg Br 83(5):635–639
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Plaschke, H.C., Thillemann, T., Belling-Sørensen, A.K. et al. Revision total elbow arthroplasty with the linked Coonrad-Morrey total elbow arthroplasty: a retrospective study of twenty procedures. International Orthopaedics (SICOT) 37, 853–858 (2013). https://doi.org/10.1007/s00264-013-1821-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-013-1821-9