Use and outcome of 1,220 primary total elbow arthroplasties from the Australian Orthopaedic Association National Joint Arthroplasty Replacement Registry 2008–2018

Figures & data

Table 1. Registry studies of TEA

Study	Registry (country)	No. of TEA	No. of prosthesis designs	Female (%)	Mean observation time (years)	No. of revisions	10-year survival (%)	Most common revision		Diagnosis
								reason	n (%)
Skytta et al. (2009)	Finland	1,457	9	87	8.2	201	83	Loosening ^a	95 (47)	RA
Jenkins et al. (2013)	Scotland	1,146	NR	74	NR	140	90	Infection	86 (61)	RA, OA, trauma
Plaschke et al. (2014)	Denmark	324	7	82	8.8	68	81	Loosening ^a	39 (57)	RA, OA, trauma
Fevang et al. (2009)	Norway	562	9	80	6^b	58	85	Loosening ^a	19 (33)	RA, OA, trauma
Krukhaug et al. (2018)	Norway	838	13	78	9^b	158	81	Loosening ^a	66 (42)	RA, OA, fracture ^c
Nestorson et al. (2018)	Sweden	406	7	90	6	18	90	Loosening ^a	7 (39)	Trauma

a Aseptic loosening

b Median.

c Fracture sequelae and acute fracture

NR = not reported. RA = rheumatoid arthritis. OA = osteoarthritis.

Table 2. Data on 1,220 primary TEA

Factor		n (%)
Elbow class
TEA without radial head component		1,177 (96)
TEA including radial head component		43 (4)
Prosthesis design
Linked	Coonrad-Morrey ^a	608 (50)
	Latitude ^a,b	344 (28)
	Nexel ^a	121 (10)
	Discovery ^a	111 (9)
	Mutars ^a	5 (< 1)
Unlinked	Latitude ^a,b	17 (1)
	IBP ^a	1 (< 1)
	Souter Strathclyde ^a	7 (1)
Undefined	Comprehensive	4 (< 1)
	Custom-made/other	2 (< 1)
Fixation technique
Cemented		1,119 (92)
Hybrid (ulnar cemented)		65 (5)
Hybrid (ulnar cementless)		32 (3)
Cementless		4 (< 1)

a Coonrad-Morrey (Zimmer, Inc., Warsaw, IN, USA), Discovery (Biomet, Inc., Warsaw, IN, USA), Nexel (Zimmer, Inc., Warsaw, IN, USA), Mutars (Implantcast GmbH, Buxtehude, Germany), Latitude (Tornier, Montbonnot-Saint-Martin, France), IBP (Biomet Inc, Warsaw, IN), Souter Strathclyde (Stryker, Rutherford, NJ, USA).

b The Latitude elbow prosthesis is a convertible design and can be placed either linked or unlinked.

Figure 1. Primary total elbow replacement by primary diagnosis.

Figure 2. Cumulative percentage revision of primary total elbow replacement (all diagnoses).

Figure 3. Cumulative percentage revision of primary total elbow replacement by primary diagnosis.

Table 4. Yearly unadjusted cumulative percentage revision (CPR (CI)) of primary total elbow replacement (all diagnoses)

	1 year	2 years	3 years	4 years	5 years	6 years	7 years	8 years	9 years
CPR (95% CI)	4 (3–5)	7 (5–8)	10 (8–12)	11 (9–14)	13 (11–15)	15 (13–18)	17 (14–20)	18 (15–21)	19 (16–22)

Figure 4. Cumulative percentage revision of primary total elbow replacement by type of primary (all diagnoses). HR adjusted for age and sex for total elbow versus total elbow & radial, entired period: HR (CI) = 1.5 (0.7–2.9). Number at risk, see below.

Figure 5. Cumulative percentage revision of primary total elbow replacement (all diagnoses). HR adjusted for age and sex for unlinked versus linked, 0–6 months: HR (CI) = 3.7 (0.9–15) and > 6 months: HR (CI) = 0.8 (0.2–2.4).

Figure 6. Cumulative percentage revision of primary total elbow replacement (all diagnoses). Only prostheses with over 100 procedures.

Table 5. Revision diagnosis of primary total elbow replacement by type of primary (all diagnoses). Values are frequency

Revision diagnosis	Total elbow	Total elbow and radial
Infection	46	3
Loosening	44	3
Fracture	13
Malposition	3
Wear bushing	3
Implant breakage ulna	2
Instability	1	2
Progression of disease	2
Arthrofibrosis	1
Implant breakage humeral	1
Incorrect aizing	1
Lysis	1
Metal related pathology	1
Prosthesis dislocation	1	1
Wear ulna	1
Other	10
No. revision	131	9
No. primary	1,177	43

Table

Number at risk at year	0	1	2	3	4	5	6	7	8	9
Coonrad-Morrey	608	539	478	392	336	267	204	149	100	59
Discovery	111	95	83	67	55	48	46	31	22	13
Latitude	361	284	229	176	147	120	94	72	52	34
Nexel	121	96	65	37	18	8	0	0	0	0

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