I'm thinking about having both my elbows replaced. I haven't heard much about elbow replacements. Never even met anyone who has one (though I know quite a few people with new hips or knees). How well do the elbows hold up? Do they last as long as hip and knee replacements?
Elbow replacements are fairly new compared to hip or knee replacements. They can be very helpful in relieving pain and improving function. But there a few downsides to be aware of and discuss with your surgeon.
In terms of reliability and durability, results are not as good for elbows as they are for hip and knee replacements. There's a much higher failure rate (15 per cent) for elbows compared with hips and knees (less than five per cent).
Loosening of the implant without infection (called aseptic loosening) is the number one complication with elbow replacements. But there have been other problems reported that require a second surgery (e.g., implant breaks, bushings wear out, mechanical failure of linkage pins).
Researchers are trying to get to the bottom of this problem. They are looking at all patient, implant, and surgical factors. For example, is younger age (with a higher activity level) the reason why TEAs come loose? Is there a specific feature (flaw?) in the implants that just doesn't work well with joint damage from trauma or the degenerative effects of osteoarthritis?
There is more than one kind of artificial elbow joint (also called a prosthesis or implant). Each one of these design features addresses a specific problem such as torn ligaments or other soft tissue damage, bone loss, and elbow deformities. Perhaps the various design features make a difference in results. Or maybe it's the underlying patient problem that contributes to complications.
So far, it looks like people of all ages with inflammatory arthritis like rheumatoid arthritis (RA) have the best results with elbow joint replacements. The implant holds up well over time. Elbow function is improved and patients are satisfied with the results.
But younger patients who either have osteoarthritis, arthritis from an injury, or a severe acute injury of the elbow seem to have a high rate of complications. This group is also more likely to need a second (revision) surgery.
Right now, there's more unknown than known about outcomes with total elbow arthroplasty (TEA). One important discovery is that there is a higher rate of revision surgeries when the implant is done outside of a joint replacement specialty hospital or center. This finding may influence where you have your surgery done.
Jay D. Keener, MD. Total Elbow Arthroplasty: What Are the Options? In Current Orthopaedic Practice. September/October 2010. Vol. 21. No. 5. Pp. 472-477.
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