State of the Art of Total Elbow Arthroplasties: Rationale, Design and Results

Total elbow athroplasties have evolved since the last years to become more reliable with reproducible results. The goal of a total elbow arthroplasty is to restore normal elbow kinematics to obtain a pain free, mobile and stable elbow. After the failure of linked constraint implants, two type of prostheses have been developed: unlinked resurfacing or anatomic implants, and linked semi-constrained implants. Unlinked implants do not have intrinsic stability, and stability is related to accurate collateral ligaments repair and soft-tissue balance. Linked implants have an intrinsic stability allowing larger spectrum of indications even when there is bone loss and ligaments deficiency. If rheumatoid arthritis was the main indication, trauma conditions and revision are becoming more frequent. The choice of the prosthesis depends on patient’s condition, etiology, local conditions, and experience of the surgeon. Rigorous and planed surgical technique adapted to the prosthesis chosen, and a perfect knowledge of the instrumentations and the different steps allow obtaining reproducible results, stable with follow-up, limiting the complication rate.