Postoperative outcomes of total elbow replacement in haemophilic elbow arthropathy: A systematic review.

Abstract

Total elbow replacement (TER) is a surgical treatment option for haemophilic elbow arthropathy. To review the outcomes of TER in haemophilic elbow arthropathy. The primary outcome measures were perioperative blood loss, postoperative complications, revision rates and length of hospital stay (LOS). Secondary outcomes were elbow range of motion (ROM), functional outcome scores and the visual analogue pain scale (VAS). PubMed, Medline, Embase and the Cochrane register were searched conforming to the PRISMA guidelines. Only studies with a minimum postoperative follow-up of 1year were included. Quality appraisal was performed utilizing the MINORS criteria. One hundred and thirty-eight articles were identified. Following article screening, only seven studies met the inclusion criteria. A total of 51 TERs in 38 patients were performed, with the Coonrad-Morrey prosthesis utilized in 51% of cases. The pooled postoperative complication and revision rates were 49% and 29%, respectively. Surgery-related postoperative mortality was 3.9%. The mean preoperative Mayo elbow performance score (MEPS) was 43±20 whereas the mean postoperative MEPS was 89±6. Mean preoperative VAS was 7.2±1.9 while the mean postoperative VAS was 2.0±1.4. Mean preoperative and postoperative elbow flexion arcs were 54±15 and 91±10 degrees, respectively. Mean preoperative and postoperative forearm rotation arcs were 86±40 and 135±19 degrees, respectively. TER for haemophilic elbow arthropathy provides good to excellent improvements in pain and elbow ROM postoperatively. However, the overall complication and revision rates are relatively high, when compared to TER performed for other indications.