Over a ten-year period, thirty-three consecutive revision total elbow
arthroplasties were performed at our institution. These were assessed at a
minimum of three years after the revision, with an average length of
follow-up of sixty-one months. Eighteen (55 per cent) of the elbows had a
good result and fifteen (45 per cent) had a poor result. The poor results
were due to infection in three elbows, loosening of the prosthesis in six,
inadequate motion in two, continued pain in two, and prosthetic failure in
two. Additional surgical revision with another implant was done in the
fifteen elbows that initially had a poor result. Eventually the result was
good in twenty-four elbows. The three elbows that became infected after
surgical revision had a resection arthroplasty and all were rated as having
a fair result. The data from this study indicated that reimplantation is a
viable option for the revision of a failed total elbow arthroplasty,
although more than one revision may be required. They also suggested that
young patients who have post-traumatic arthritis should not undergo a total
joint replacement, and that revision procedures should be performed in
settings that can offer several surgical options and by surgeons who have
had experience with these options. Alternatives to reimplantation as a
revision procedure should be considered in selected patients.