Non-septic Revision Total Elbow Arthroplasty

Abstract

This chapter covers the spectrum of currently performed aseptic revision techniques. We have limited the coverage to that of functional revision procedures. Hence nonreplacement and nonfunctional salvage procedures, such as resection and fusion, are not considered. The emphasis is on the indications for and execution of the several revision strategies available with documented outcomes. With time the predominant mode of failure has changed based on the design features of the primary device and the overall improved longevity of the current designs. The relentless trend is that of increasing technical difficulty required to address the greater magnitude of osseous deficiency. We review the techniques and considerations when recementing without osseous augmentation. Also discussed are the techniques used to remove a fractured well-fixed stem. The topic of bone struts, essential in many circumstances, is considered in detail. Finally the evolving use of allograft prosthetic composites is reviewed in detail. The indications for and technical considerations for three distinct APC reconstructions are presented and illustrated with clinical examples. The evolution of the APC concept is embedded in the review, thus providing the most current information on this subject.