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American Association for Hand Surgery

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Total Elbow Replacement: Hong Kong Experience
Hin-Keung Wong, MD, Princes Margaret Hospital, Hong Kong, Hong Kong

Introduction

Total elbow replacement (TER) was initially designed to treat end-stage secondary osteoarthritis of elbow joints in patients with rheumatoid arthritis. It is increasingly used for treating comminuted fractures of the distal humerus in the elderly patients. It is superior to open reduction and internal fixation particularly for AO type C distal distal humeral fractures. The complication rates associated with TER is higher than those associated with replacement of knee joints and hip joints. The longevity of TER is also lower than that of total knee replacement and total hip replacement. Improvements in TER design and surgical techniques can reduce the complication rates and improve the longevity of TER. We reported the functional outcome and implant survival of TER in a local hospital in Hong Kong from 2005 to 2017.

Methods

A total of 16 TER were performed in Princess Margaret Hospital from 2005 to 2017. The total arc of motion was 50 - 140 degrees (average 80.4). There was no major complication. One patient experienced occasional locking of the joint on movements. On patient had transient ulnar nerve palsy and spontaneous full recovery of nerve function. One patient had severe wearing of the bushing and loosening of the hinge which required revision of the components 11 years after the initial surgery.

Conclusion

The review of our experience suggested that TER can give good functional outcome and survival rate in short to mid terms. It is a useful surgical treatment for end-stage osteoarthritis of the elbow joints or comminuted fractures of the distal humerus in elderly patients.


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