(ii) Total elbow arthroplasty

SummaryElbow arthroplasty has an important role in the treatment of many conditions affecting the elbow, including inflammatory arthritis, osteoarthritis, fracture and instability. The types of implant differ in the degree of constraint they provide. Some are linked and highly constrained implants, whereas others have a “sloppy hinge” which allows some varus/valgus play. Yet others are completely unlinked and provide the least constraint, relying on ligament and muscle balance for stability. A variety of implants have achieved good results in terms of pain relief and range of movement, which usually leads to significant functional benefit to the patient.However, this surgery is not without risk and the main complications include loosening, infection, instability, dislocation and nerve dysfunction. As with other forms of arthroplasty, but particularly the elbow, it is important to scrutinise the indication for surgery when considering the results of elbow arthroplasty; the majority of procedures are performed for inflammatory arthritis. The precise difference in outcome between unlinked, linked and sloppy articulations appears to be small and the exact role for each implant type is yet to be precisely defined.