Sixteen patients who received nineteen semiconstrained total elbow
replacements for complete ankylosis of the elbow were followed for an
average of five and three-quarters years (range, two to twelve years). The
average preoperative elbow score was 23 points and the average
postoperative score was 84 points. Postoperatively, the average flexion was
115 degrees; extension, 35 degrees; and pronation and supination, 95
degrees. There were fifteen excellent or good results. There was one
failure due to a deep infection, but after removal of the prosthesis a
satisfactory fascial arthroplasty was achieved in this elbow. Function was
improved in all patients, and all patients had relief of the preoperative
pain. For the arthroplasty to succeed, the patient must have a good
understanding of the procedure and must be willing and able to comply with
the postoperative rehabilitation program. The use of a semiconstrained,
often custom-fit, implant is necessary. The Bryan-Morrey posteromedial
approach to the elbow is recommended for the procedure, since this approach
allows early institution of range-of-motion exercises.