Notching of smooth ulnar stems reduces loosening after total elbow arthroplasty

Abstract

Background This study aimed to validate the concept of notching of the ulna component of the first-generation latitude total elbow prosthesis to reduce the rate of aseptic loosening and improve implant survival. Methods A total of 18 total elbow arthroplasty cases were performed between June 2001 and May 2002 using the latitude first-generation ulnar stem. A total of 14 cases with at least 2 years of follow-up were evaluated following the exclusion of four infected cases. The senior author roughened the stem surface with notches in 10 cases (notched group) to prevent loosening. The effects of notching on implant failure were retrospectively analyzed. Results Average participant age and follow-up were 56 ± 20 years and 72 ± 44 months, respectively. The notched and unnotched implant groups were demographically equivalent. 3/4(75%) of unnotched group implants failed due to aseptic loosening. 1/10(10%) of the notched group implants failed. All unnotched group aseptic loosening cases occurred at the bone–cement interface within 2 years after total elbow arthroplasty. The single patient with aseptic loosening in the notched group had a history of multiple surgeries due to an open fracture preceding the primary total elbow arthroplasty. Discussion Notching of the ulna component of the first-generation latitude total elbow prosthesis reduced the rate of aseptic loosening and improved implant survival. Level of evidence Level IV, retrospective comparative study.