Total elbow arthroplasty in the face of significant bone stock or soft tissue losses. Preliminary results of custom-fit arthroplasty.

There is a class of patients with severe bone stock or soft tissue losses who remain an unsolved problem in elbow reconstruction. The authors report the results of 16 such patients who underwent 16 total elbow replacements. Follow-up averaged 4.0 years (range, 2.0-9.6 years). Fourteen patients had previous surgery on their elbows and three had been previously infected. Fourteen of the 16 patients had a good or excellent result, and overall elbow scores averaged 90 (range, 53-100). There were three reoperations and one case of nonprogressive circumferential lucent lines about a humeral component with clinical symptoms. There were no other cases of clinical or radiographic implant loosening and no implant fractures. The preliminary results of this study indicate that custom-fit total elbow arthroplasty offers acceptable functional results in a devastated elbow when normal methods of reconstruction are not suitable.