Short-term clinical results of revision elbow arthroplasty using the Latitude total elbow arthroplasty

Bone Joint J. 2016 Aug;98-B(8):1086-92. doi: 10.1302/0301-620X.98B8.35025.

Abstract

Aims: Revision total elbow arthroplasty (TEA) is often challenging. The aim of this study was to report on the clinical and radiological results of revision arthroplasty of the elbow with the Latitude TEA.

Patients and methods: Between 2006 and 2010 we used the Latitude TEA for revision in 18 consecutive elbows (17 patients); mean age 53 years (28 to 80); 14 women. A Kudo TEA was revised in 15 elbows and a Souter-Strathclyde TEA in three. Stability, range of movement (ROM), visual analogue score (VAS) for pain and functional scores, Elbow Functional Assessment Scale (EFAS), the Functional Rating Index of Broberg and Morrey (FRIBM) and the Modified Andrews' Elbow Scoring System (MAESS) were assessed pre-operatively and at each post-operative follow-up visit (six, 12 months and biennially thereafter). Radiographs were analysed for loosening, fractures and dislocation. The mean follow-up was 59 months (26 to 89).

Results: The ROM of the elbow did not improve significantly. The mean EFAS and MAESS scores improved significantly six months post-operatively (18.6 points, standard deviation (sd) 7.7; p = 0.03 and 28.8 points, sd 8.6; p = 0.006, respectively) and continued to improve slightly or reached a plateau. The mean pain scores at rest (Z = -3.2, p = 0.001) and during activity (Z = -3.2, p = 0.001), and stability (Z = -3.0, p = 0.003) improved significantly six months post-operatively. Thereafter scores continued to improve slightly or a plateau was reached. There were no signs of loosening.

Conclusion: Revision surgery using the Latitude TEA results in improvement of functionality, reduced pain and better stability of the elbow. Improvement of ROM of the elbow should not be expected. Cite this article: Bone Joint J 2016;98-B:1086-92.

Keywords: Arthroplasty; Convertible; Elbow; Revision.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Elbow / instrumentation
  • Arthroplasty, Replacement, Elbow / methods*
  • Elbow Prosthesis
  • Female
  • Follow-Up Studies
  • Humans
  • Humeral Fractures / diagnostic imaging
  • Humeral Fractures / physiopathology
  • Humeral Fractures / surgery
  • Joint Dislocations / diagnostic imaging
  • Joint Dislocations / surgery
  • Joint Instability / surgery
  • Male
  • Middle Aged
  • Pain, Postoperative / prevention & control
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / surgery
  • Prosthesis Failure / adverse effects
  • Prosthesis-Related Infections / diagnostic imaging
  • Prosthesis-Related Infections / surgery
  • Range of Motion, Articular / physiology
  • Reoperation
  • Therapeutic Irrigation / methods
  • Treatment Outcome
  • Young Adult