Long-Term Outcomes of Total Elbow Arthroplasty - A Systematic Review of Studies at 10-Year Follow-Up.

BACKGROUND: The purpose of this study was to systematically review the literature to evaluate the functional outcomes, dislocation and revision rates following total elbow arthroplasty (TEA) at a minimum 10 years' mean follow-up. MATERIALS AND METHODS: Two independent reviewers performed a literature search using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using PubMed, Embase and Cochrane Library databases. Studies were only included if they focused on outcomes post-TEA at a minimum 10 years' mean follow-up. RESULTS: Our search found 23 studies including 1429 elbows (60.4% linked TEA), which met our inclusion criteria. There were 1276 patients (79.0% female), with average age of 64.7 years (19-93) and mean follow-up of 137.2 months (120-216). At final follow-up, the mean Mayo Elbow Performance Score (MEPS), Oxford Elbow Score (OES) and Quick Disabilities of Arm, Shoulder & Hand (QuickDASH) scores were 89.1 (35-100), 64.4 (16-48) and 39.2 (3-93) respectively, and 63.3% of patients reported having no pain. The rates of aseptic loosening, infection, implant dislocation and nerve injury were 12.9%, 3.3%, 4.2% and 2.1% respectively. The overall complication and revision rates were 16.3% and 14.6% respectively. DISCUSSION AND CONCLUSION: Our systematic review established that total elbow arthroplasty offers patients satisfactory clinical outcomes at long-term follow-up, with relatively stable revision and complication rates compared to short- and medium-term.