Experience with the Coonrad-Morrey total elbow arthroplasty: 78 consecutive total elbow arthroplasties reviewed with an average 5 years of follow-up

• Published in: Journal of shoulder and elbow surgery 2013-11, Vol.22 (11), p.1461-1468
• Main Authors: Mansat, Pierre, MD, PhD, Bonnevialle, Nicolas, MD, Rongières, Michel, MD, Mansat, Michel, MD, Bonnevialle, Paul, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Arthritis - surgery; arthroplasty; Arthroplasty, Replacement, Elbow - instrumentation; Elbow; Elbow Joint - injuries; Elbow Joint - surgery; Elbow Prosthesis; Female; Follow-Up Studies; fracture; Fractures, Bone - surgery; Humans; Joint Diseases - surgery; Male; Middle Aged; Orthopedics; rheumatoid; trauma; Treatment Outcome
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2013.07.042

Background The Coonrad-Morrey total elbow arthroplasty is a linked implant. This study investigated the hypotheses that reliable results can be obtained in rheumatoid patients and in traumatic conditions and that the survival rate is similar to or better than what has been published for nonlinked implants. Methods Surgery was performed on 70 consecutive patients (78 elbows) for an inflammatory arthritis (45 elbows) or a traumatic condition (33 elbows: 18 acute fractures of the distal humerus, 10 nonunions, and 5 post-traumatic arthritis). Results At an average of 5 years of follow-up (2 to 11 years), the mean Mayo Elbow Performance Score for the group that had inflammatory arthritis (89 ± 13 points) was significantly higher than that for the group with a traumatic condition (80 ± 17 points). The QuickDASH score was not significantly different according to the etiology. Radiolucencies were observed in 17 cases around the humeral component and in 14 cases around the ulnar component. Bushing wear was observed in 14 cases. There were 27 complications, and 9 of them went to a revision procedure. The survival rate was 97.7% at 5 years and 91.0% at 10 years if we consider revision for aseptic loosening as an endpoint. Conclusions The Coonrad-Morrey total elbow arthroplasty allows treatment of a large spectrum of causes with satisfactory results. Better results have been obtained for rheumatoid patients than for patients with trauma. The rate of complication remains high even if the rate of implant revision stays low. However, the increased incidence of lucent lines around the ulnar component with follow-up and bushing wear are of concern.