Extended Olecranon Osteotomy for Revision Total Elbow Arthroplasty

Abstract

Widening surgical indications for total elbow arthroplasty have resulted in increasing rates of implantation over the past several years. The need for advanced surgical techniques in the event of revision surgical treatment has become more apparent with time. Extraction of the ulnar component can be particularly challenging if well-fixed. The extended olecranon osteotomy for exposure of the ulnar intramedullary canal, cement mantle, and component was developed to address these concerns. Cadaveric dissection, implantation, osteotomy, and extraction of a total elbow arthroplasty were performed using an extended olecranon osteotomy. An illustrative surgical case is also included with pertinent intraoperative and radiographic images. This technique for extended olecranon osteotomy provides reliable, atraumatic access to the ulnar canal, cement mantle, and component for safe extraction of a well-fixed implant. The osteotomy configuration provides a large surface area for bony healing, thus restoring the integrity of the proximal ulna for later cemented reimplantation. The patient displayed osteotomy healing despite concomitant treatment for a periprosthetic joint infection.