An overview and challenges of revision total elbow arthroplasty

Abstract

Since the introduction of modern total elbow arthroplasty (TEA), there has been a rapid evolution in the understanding of elbow biomechanics, surgical techniques, and improvements in implant materials and design. Aimed originally to treat primarily end-stage rheumatoid arthritis, the indications for TEA have extended to include post-traumatic arthritis, primary osteoarthritis and acute non-reconstructable fractures of the distal humerus. Implant survivorship in TEA is substantially longer in patients with inflammatory arthritis when compared to trauma-related indications. The leading causes of revision are infection, aseptic loosening secondary to polyethylene wear and mechanical failure, and periprosthetic fractures. This article aims to provide an overview on revision TEA and the challenges associated with management of failed primary elbow arthroplasty.