How long does an elbow replacement last? A systematic review and meta-analysis of case-series and national registry reports with more than 10 years of follow-up

Evans, Jonathan P; Evans, Jonathan; Mohammad, Hasan R; Sayers, Adrian; Blom, Ashley; Whitehouse, Michael R; Rees, Jonathan

doi:10.2340/17453674.2022.2753

Cited by 8 publications

(9 citation statements)

References 24 publications

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“…With regard to elbow arthroplasty Evans et al 13 reported, in their systematic review and meta-analysis of case series and registry data, 92% 10-year survival for 628 linked total elbow replacements and 10-year PROMs from elbow replacements revealed a substantial improvement from baseline scores, again suggesting good longevity.…”

Section: Does Follow-up Beyond One Year Identify the Asymptomatic Fai...mentioning

confidence: 99%

Scoping review: Evidence for long-term follow-up and monitoring in shoulder and elbow arthroplasty

et al. 2023

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Aims Long-term follow-up and monitoring of asymptomatic shoulder and elbow arthroplasty remains contentious, with a wide spectrum of non-evidence-based mechanisms used. This scoping review aims to outline related evidence, thereby informing research requirements. Methods Studies relevant to shoulder and elbow arthroplasty follow-up, surveillance and time-related failure were included. The review included randomised controlled trials, systematic reviews and economic studies indexed in MEDLINE, Embase, Cochrane CDSR and Cochrane CENTRAL since 1 January 2012. In addition, all registry studies, follow-up studies, cohort studies and case reports indexed in MEDLINE since 1 January 2020 were included. The screening was undertaken by two reviewers. Key characteristics of each study were described, alongside a narrative review. Results Twenty-one articles were included. We were unable to identify evidence that long-term follow-up and monitoring of asymptomatic shoulder and elbow arthroplasty identifies failure or leads to a revision that is of reduced patient morbidity and cost. In addition, no evidence was apparent to inform whether patients will self-present with a failing implant. Several surveillance mechanisms were identified. Conclusion This scoping review highlights the paucity of evidence related to long-term follow-up and monitoring of shoulder and elbow arthroplasty, and the need for high-quality data to inform the development of evidence-based care pathways.

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Section: Does Follow-up Beyond One Year Identify the Asymptomatic Fai...mentioning

confidence: 99%

Scoping review: Evidence for long-term follow-up and monitoring in shoulder and elbow arthroplasty

et al. 2023

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“…The 25-year survivorship of total knee replacement from registries is 82% (Evans et al., 2019b). The reported 10-year survival rate for shoulder arthroplasty is 92% (Evans et al., 2020), for linked total elbow replacement 92% (Evans et al., 2022) and for ankle replacement 66% (Perry et al., 2022). In comparison, the highest reported survival rate for fourth-generation TWA at 15-year follow-up is 78% (Gil et al., 2017).…”

Section: Introductionmentioning

confidence: 99%

Complications after total wrist arthroplasty

Boeckstyns,

Herzberg

2024

J Hand Surg Eur Vol

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We reviewed the incidence and management of complications after total wrist arthroplasty, as reported in the literature, with so-called fourth-generation implants and other recent designs. While early intraoperative and postoperative complications, including fractures, tendon lacerations, infection, nerve compression, tendonitis, stiffness and chronic regional pain syndrome, had an acceptable incidence, late complications, such as periprosthetic osteolysis and implant loosening, occurred more frequently. Implant survival at 10 years was in the range of 70%–80% in most publications. Several of the implants have been modified or withdrawn. Instability and dislocation were frequent after a pyrocarbon spacer. Failed arthroplasties can be salvaged by revision arthroplasty or total wrist arthrodesis. Revision arthroplasty has a lower survival rate than primary arthroplasty and does not clearly offer important significant advantages over total wrist arthrodesis in terms of patient-reported outcome measures. Further development of prosthetic design, new materials and more knowledge on patient-related risk factors are needed.

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“… 1 However, despite technological advances, TEA continues to have higher failure rates than arthroplasty of the hip and knee. 2 - 5 …”

Section: Introductionmentioning

confidence: 99%

Prognostic factors associated with failure of total elbow arthroplasty

Hamoodi,

Gehringer,

Bull

et al. 2024

Bone Joint Res

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AimsThe aims of this study were to identify and evaluate the current literature examining the prognostic factors which are associated with failure of total elbow arthroplasty (TEA).MethodsElectronic literature searches were conducted using MEDLINE, Embase, PubMed, and Cochrane. All studies reporting prognostic estimates for factors associated with the revision of a primary TEA were included. The risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool, and the quality of evidence was assessed using the modified Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. Due to low quality of the evidence and the heterogeneous nature of the studies, a narrative synthesis was used.ResultsA total of 19 studies met the inclusion criteria, investigating 28 possible prognostic factors. Most QUIPS domains (84%) were rated as moderate to high risk of bias. The quality of the evidence was low or very low for all prognostic factors. In low-quality evidence, prognostic factors with consistent associations with failure of TEA in more than one study were: the sequelae of trauma leading to TEA, either independently or combined with acute trauma, and male sex. Several other studies investigating sex reported no association. The evidence for other factors was of very low quality and mostly involved exploratory studies.ConclusionThe current evidence investigating the prognostic factors associated with failure of TEA is of low or very low quality, and studies generally have a moderate to high risk of bias. Prognostic factors are subject to uncertainty, should be interpreted with caution, and are of little clinical value. Higher-quality evidence is required to determine robust prognostic factors for failure of TEA.Cite this article: Bone Joint Res 2024;13(5):201–213.

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How long does an elbow replacement last? A systematic review and meta-analysis of case-series and national registry reports with more than 10 years of follow-up

Cited by 8 publications

References 24 publications

Scoping review: Evidence for long-term follow-up and monitoring in shoulder and elbow arthroplasty

Scoping review: Evidence for long-term follow-up and monitoring in shoulder and elbow arthroplasty

Complications after total wrist arthroplasty

Prognostic factors associated with failure of total elbow arthroplasty

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