Indications and outcomes of the Coonrad-Morrey total elbow arthroplasty: a systematic review.

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Abstract

[Indexed for MEDLINE] 15. Shoulder Elbow. 2020 Oct;12(5):353-361. doi: 10.1177/1758573219873001. Epub 2019 Sep 12. Indications and outcome in total elbow arthroplasty: A systematic review. Samdanis V(1), Manoharan G(1), Jordan RW(1), Watts AC(2), Jenkins P(3), Kulkarni R(4), Thomas M(5), Rangan A(6), Hay SM(1). Author information: (1)Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK. (2)Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK. (3)Glasgow Royal Infirmary, Glasgow, UK. (4)Royal Gwent Hospital, Newport, UK. (5)Frimley Health NHS Foundation Trust, Frimley, UK. (6)South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK. BACKGROUND: Total elbow arthroplasty (TEA) is the established treatment for end-stage rheumatoid arthritis but improved surgical techniques have resulted in expanded indications. The aim of this study is to review the literature to evaluate the evolution of surgical indications for TEA. METHODS: A systematic review of PubMed and EMBASE databases was conducted. Case series and comparative studies reporting results after three types of primary TEA were eligible for inclusion. RESULTS: Forty-nine eligible studies were identified (n = 1995). The number of TEA cases published annually increased from 6 cases in 1980 to 135 cases in 2008. The commonest indication for TEA throughout the review period was rheumatoid arthritis but its annual proportion reduced from 77% to 50%. The mean Mayo Elbow Performance Score significantly improved for all indications. Three comparative studies reported statistically improved functional outcomes in rheumatoid arthritis over the trauma sequelae group. Complication and revision rates varied; rheumatoid arthritis 5.2-30.9% and 11-13%, acute fracture 0-50% and 10-11%, trauma sequelae 14.2-50% and 0-30%, osteoarthritis 50% and 11%, respectively. DISCUSSION: TEA can provide functional improvements in inflammatory arthritis, acute fractures, trauma sequelae and miscellaneous indications. Long-term TEA survivorship appears satisfactory in rheumatoid arthritis and fracture cases; however, further research into alternative surgical indications is still required. © 2019 The British Elbow & Shoulder Society. DOI: 10.1177/1758573219873001 PMCID: PMC7545529