Total Elbow Arthroplasty in Rheumatoid Arthritis and Other Inflammatory Conditions: Unlinked or Linked Replacement?

Abstract

Many conditions can affect the elbow and lead to arthroplasty, including rheumatoid arthritis, juvenile rheumatoid arthritis, spondyloarthropathies, crystalline-induced arthropathies and adult Still’s disease. In this chapter, the authors describe the pathophysiology, clinical presentation and treatment of these different conditions, also named “inflammatory pathologies”, with a focus on surgical treatment. In particular, clinical recommendations on the choice of implant to best match the pathoanatomic pattern of this wide spectrum of pathologies are made based on a thorough review of the literature. The implants commonly used can be linked, unlinked or convertible. Implant selection is based on bone stock quality and collateral ligament and muscular tissue effectiveness. The aim is to achieve pain relief, functional arc of motion and a stable joint with a high survival rate. If the surgical technique is correct, total elbow arthroplasty (TEA) performed by expert surgeons can lead to excellent outcomes in accurately selected patients.