Long term follow-up of semi-constrained total elbow arthroplasty: a single centre retrospective analysis

Abstract

Total elbow arthroplasty (TEA) is an effective treatment for end-stage elbow arthritis and fractures, with semi- constrained designs demonstrating superior outcomes in stability and implant longevity. However, long-term survival and clinical performance data remain limited. This single-center retrospective study analyzed 122 patients who underwent semi-constrained TEA between 2003 and 2019. The cohort included 94 Coonrad-Morrey, 17 Nexel, and 11 Latitude prostheses. Clinical outcomes were assessed using Visual Analogue Scale (VAS) for pain and satisfaction, Disabilities of the Arm, Shoulder and Hand (DASH), and Mayo Elbow Performance Score (MEPS). Radiographic evaluations identified aseptic loosening and periprosthetic fractures. Kaplan-Meier survival analysis was performed to determine implant longevity. Mean follow-up durations varied across implant designs, with the Coonrad-Morrey group averaging 7.4 years. The 5-, 10-, and 15-year survival rates were 96%, 92%, and 70% for Coonrad-Morrey, 100% and 82% for Latitude (at 5 and 10 years), and 78% for Nexel at 5 years. Complication rates differed among prostheses, with Nexel showing the highest rate (41.2%), followed by Latitude (36.3%) and Coonrad-Morrey (20.6%). Functional outcomes were comparable across groups, with mean DASH scores of 33.3 (Coonrad-Morrey), 32.2 (Latitude), and 22.3 (Nexel), and mean MEPS scores of 88.7, 93.7, and 90.6, respectively.Semi-constrained TEA provides reliable pain relief, functional restoration, and implant survival, with variations in outcomes among different prosthetic designs. The Coonrad-Morrey prosthesis exhibited the highest long-term survival, while Nexel demonstrated higher early complication rates. Further longitudinal studies are needed to optimize implant design and patient selection to enhance long-term TEA performance.