Abstract

Third generation total elbow arthroplasty (TEA) have shown better mechanical characteristics than older designs. However, these results remain purely mechanical and lack clinical evidence. The purpose of this study was to evaluate clinical and radiographic outcomes of the new generation semi-constrained Nexel TEA performed at our center. Between 2015 and 2017, 9 Nexel TEA were implanted in 9 patients (mean age 61 years, range 38 to 71). Indication for further surgery, range of motion, mean Mayo elbow performance score (MEPS), subjective elbow value (SEV), radiolucency lines, outcome measures that included implant survival, complications and revisions were assessed. Average follow-up was 28 months (5 to 46 months). Average range of motion significantly improved from preoperative to postoperative, with flexion from 120° (70 to 140°) to 140° (130 to 155°) and supination from 60° (0-80°) to 80° (80°). Average MEPS improved from 33 (5-45) to 85 points (30-95). During the study period, 5 (56%) elbows experienced complications, and 2 (22%) underwent revision. Aseptic humeral loosening was the main indication for revision. Survivorship rate without revision was 75 % at 45 months. The short-term clinical results of the Nexel TEA are satisfactory. However, an unusual high rate of complication and revision was observed, mainly at the humeral component. Further research with longer follow-up and more patients included are needed to validate this new prosthesis.

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