Unicompartmental Elbow Replacement

Postmortem studies have shown that advanced degenerative changes occur in the radiocapitellar (lateral) compartment of elbow joints in elderly subjects in whom the humeroulnar (medial) compartment remains well preserved. We have observed a similar pattern of degenerative change in younger symptomatic patients undergoing arthroscopic debridement procedures or open arthrolysis. We have found that the clinical improvement obtained by these procedures is unpredictable, and persisting rest pain is a problem. We therefore recognized the need to develop prosthetic components with which to replace or resurface the articular surfaces of the lateral compartment of the elbow. The resulting lateral resurfacing elbow arthroplasty began clinical evaluation in September 2005 and to date has been inserted into 44 elbows (43 patients). The purpose of this article is to outline the design rationale, describe the surgical technique, and present the early results of the lateral resurfacing elbow arthroplasty. Our early experiences have broadened our indications for surgery beyond patients with primary osteoarthritis and now include patients with secondary osteoarthritis due to trauma or rheumatoid disease.