However, techniques for elbow and wrist arthroplasty have been much slower to develop, due to lower incidence of pathology, the unique functional demands on these joints, and prosthetic-design and fixation issues. Still, the Conrad-Morrey family of implants has provided reliable elbow prostheses for more than 20 years. Meanwhile, the indications for elbow arthroplasty have narrowed to inflammatory arthritis and distal humeral fractures and nonunions in patients with lower functional demands. Unfortunately, failure of fixation, infection, and bone resorption do occur after primary elbow arthroplasty; consequently, a small but growing number of patients face revision elbow arthroplasty.
In the November 18, 2020 issue of The Journal, Burnier et al. report the results of revision elbow arthroplasty using a proximal ulnar allograft-prosthetic composite to compensate for missing ulnar bone stock and triceps tendon insufficiency. They clearly explain the surgical technique and report their results among a 10-patient cohort, including details of the 6 cases that required reoperation.
JBJS will continue reporting results of revision joint arthroplasty because members of the orthopaedic community have to manage these very complex cases, and this type of information is helpful to guide treatment decisions and patient expectations. Equally important is the positive impact this information has on further development of surgical techniques and prosthetic designs. Close examination of failure is the fuel for innovative improvement.
Marc Swiontkowski, MD
JBJS Editor-in-Chief