Background and study aim: Total elbow arthroplasty (TEA) has gained popularity in recent years, with most surgeons favoring cemented elbow prostheses. The objective of this study was to evaluate the outcome of our series and if specific radiological cementation criteria may predict clinical outcome.
Material and methods: All patients submitted to cemented TEA were retrospectively reviewed over a 10-year period in an institution. All radiographs performed in the immediate postoperative period were blindly evaluated and classified according to specific cementation criteria. The radiographs of the last medical appointment were also blindly evaluated for possible signs of loosening, with a minimum followup of 4 years. The complication rate, revision rate, average prosthesis survival and QuickDASH Score were also evaluated. Statistical analysis was then performed to evaluate whether cementation quality had an influence on clinical and radiological results.
Results: A total of 31 TEA were identified. Patients with an inadequate or marginal ulnar cementation were 9.2 times more likely of having a cubital loosening (p=0.032; OR=9.2[95% CI 1-91]). However, inadequate or marginal humeral cementation did not have a statistically significant association with the presence of humeral loosening (p=0.27). In our sample, there were 4 cases of aseptic loosening requiring revision. In all of them there were marginal or inadequate cementations in one of the components.
Conclusions: This work highlighted the importance of adequate cementation and radiological evaluation. From this study, we can conclude that poor ulnar cementation may predict radiological loosening and eventual need for revision. However, this loosening does not correlate with the patient’s clinical outcomes or the need for revision.
Total elbow arthroplasty, Cementation criteria, Aseptic loosening, Quick DASH Score