A New Approach to Elbow Arthroplasty

Abstract

The development of a two component endoprosthesis, the articular surfaces of which are modelled very closely on those of the normal trochlear joint, is described. Fixation is achieved through the use of methyl methacrylate cement around a keel and stem on the ulnar side and around a supracondylar metal stirrup with projecting flanges in the capitellum and medial epicondyle in the humerus. In vitro studies suggest that this fixation should be adequate to resist the forces normally transmitted across the elbow, these forces ranging according to the activity from half to three times body weight.Early clinical results have proved very satisfactory with regard to relief of pain and recovery of flexion, pronation, supination, power and function as a whole. The recovery of lost extension has proved more elusive. A much longer follow-up of two to five years will be required in order to ascertain whether the problem of loosening has been solved.