Skip to main content

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

  • Chapter
  • First Online:
Elbow Arthroplasty
  • 494 Accesses

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Amirfeyz R, Stanley D. Allograft-prosthesis composite reconstruction for the management of failed elbow replacement with massive structural bone loss: a medium-term follow-up. J Bone Joint Surg Br. 2011;93(10):1382–8.

    Article  CAS  PubMed  Google Scholar 

  2. Chan RKW, King GJW. The management of the failed total elbow arthroplasty. Operative elbow surgery: Expert Consult. 2012;44:665–95.

    Article  Google Scholar 

  3. Ramirez MA, Cheung EV, Murthi AM. Revision total elbow arthroplasty. J Am Acad Orthop Surg. 2017;25(8):e166–74.

    Article  PubMed  Google Scholar 

  4. Pessis E, Campagna R, Sverzut JM, Bach F, Rodallec M, Guerini H, Feydy A, Drapé JL. Virtual monochromatic spectral imaging with fast kilovoltage switching: reduction of metal artifacts at CT. Radiographics. 2013;33(2):573–83.

    Article  PubMed  Google Scholar 

  5. Stanley D. Revision total elbow arthroplasty in the presence of bone deficiency. Operative elbow surgery: Expert Consult. 2012;44:695–716.

    Article  Google Scholar 

  6. Rotini R, Bettelli G, Cavaciocchi M, Savarino L. Pseudotumor due to metallosis after total elbow arthroplasty. Indian J Orthop. 2017;51(1):103–6.

    Article  PubMed  PubMed Central  Google Scholar 

  7. O’Driscoll SW. The triceps-reflecting anconeus pedicle (TRAP) approach for distal humeral fractures and nonunions. Orthop Clin North Am. 2000;31(1):91–101.

    Article  PubMed  Google Scholar 

  8. Bernard F, Morrey BF. Master techniques in orthopaedic surgery: the elbow, Wolters Kluwer 2014;39:773–822.

    Google Scholar 

  9. Rhee YG. Impaction grafting in revision total elbow arthroplasty due to aseptic loosening and bone loss. J Bone Joint Surg Am. 2013;95A(994)

    Google Scholar 

  10. Mansat P, Adams RA, Morrey BF. Allograft-prosthesis composite for revision of catastrophic failure of total elbow arthroplasty. J Bone Joint Surg Am. 2004;86-A(4):724–35.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Ritali .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ritali, A., Cavallo, M., Zaccaro, R., Ricciarelli, M., Rotini, R. (2020). Revision in Total Elbow Replacement with Bone Stock Loss: Surgical Technique and Expected Results. In: Castoldi, F., Giannicola, G., Rotini, R. (eds) Elbow Arthroplasty . Springer, Cham. https://doi.org/10.1007/978-3-030-14455-5_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-14455-5_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-14454-8

  • Online ISBN: 978-3-030-14455-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics