Failure of the Hinge Mechanism in Total Elbow Arthroplasty

Author(s): Seitz W, Bismar H, Evans PJ

Source: J Shoulder Elbow Surg 19: 368-75, 2010.

Summary:

This is a retrospective review of 82 total elbow arthroplastys performed over the past 8 years.  The authors hypothesized that the mechanical properties of the second generation hinge mechanism of the Coonrad- Morrey Elbow prosthesis are inadequate to resist the high stresses placed upon it by younger active patients.  The authors reviewed the mode of failure, radiographic and clinical findings in the second generation Coonrad-Morrey Total Elbow.   The results demonstrate that there were 5 of 82 patients had revision surgery due to the central axis locking mechanism.   The average time between index procedure and time of failure was 25 months.  These patients presented with pain, squeaking and also had gross instability.

The significance of this article demonstrates that younger patients with total elbow arthroplasties should be monitored closely for failure of the central locking mechanism.