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Revision in Total Elbow Replacement with Bone Stock Loss: Surgical Technique and Expected Results

  • A. RitaliEmail author
  • M. Cavallo
  • R. Zaccaro
  • M. Ricciarelli
  • R. Rotini
Chapter

Abstract

Mobilizations of total elbow arthroplasties are fairly infrequent conditions, but elbow prosthesis revision, especially in case of bone loss, is very demanding. There is necessity of multiple surgical equipments, grafts, and dedicated instruments. On the other side, procrastinating the surgery exposes the risk of further bone loss, worsening muscle atrophy and increasing the risk of fracture. It is essential to understand the mechanism of failure of a prosthetic implant, immediately distinguishing between failures due to an underlying infection and those due to an aseptic loosening, or a periprosthetic fracture. Aseptic loosening is the most frequent cause of failure. The choice of the type of surgery should be guided by the size and location of loss of bone substance. In any case the use of a graft is mandatory in prosthetic revisions with loss of bone stock, mainly because the graft increases the bone stock, helps to bridge bone defects, and provides temporary structural support for implant stability.

The most frequently reported complications after elbow prosthesis revision are periprosthetic fractures and cortical perforation, nerve injuries, infections, and triceps insufficiency or avulsion.

Keywords

Elbow replacement Elbow revision Aseptic loosening Bone loss Bone graft 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • A. Ritali
    • 1
    Email author
  • M. Cavallo
    • 1
  • R. Zaccaro
    • 1
  • M. Ricciarelli
    • 1
  • R. Rotini
    • 2
  1. 1.UO Chirurgia Spalla e GomitoIstituto Ortopedico RizzoliBolognaItaly
  2. 2.Department Shoulder and Elbow SurgeryIRCCS Rizzoli Orthopaedic InstituteBolognaItaly

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