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Total Elbow Arthroplasty Complication, Reoperation, and Revision Rates: A Comparison Between Arthroplasty for Arthritis Versus Fracture
Journal article   Peer reviewed

Total Elbow Arthroplasty Complication, Reoperation, and Revision Rates: A Comparison Between Arthroplasty for Arthritis Versus Fracture

Evgeniy V. Uvarov, Keyur Patel, Jeremiah A. Adams, Adam Nehmeh, Mohammad Khak and Asif M. Ilyas
Journal of hand surgery global online, v 8(3), p100981
May 2026
DOI: https://doi.org/10.1016/j.jhsg.2026.100981
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https://doi.org/10.1016/j.jhsg.2026.100981View
Published, Version of Record (VoR) Open

Abstract

Distal humerus fracture Elbow arthritis Postoperative complications Reoperation Total elbow arthroplasty
Total elbow arthroplasty (TEA) can be used to treat both distal humerus fractures and arthritis of the elbow joint. This study aimed to compare complication, reoperation, and revision rates following TEA between these two indications. A retrospective review of TEA was performed within a single large orthopedic practice. All patients who had undergone a TEA between 2016 and 2020, yielding 96 TEA cases for analysis, were queried. TEA cases were categorized by indication into arthritis diagnoses (AX) and distal humerus fractures (FX). Demographic and clinical data, complications, reoperations, and revisions were recorded over a 4-year follow-up period. Kaplan-Meier implant survival and multivariable analyses were performed. A total of 96 TEAs (54 AX and 42 FX) with a mean age of 70.3 ± 12.4 years were included, among which 78% (75/96) were women. Patients in the AX group (64.8 ± 10.9 years) were younger than those in the FX group (77.5 ± 10.5 years). The overall TEA complication rate was 42%, and the reoperation rate was 23%. The AX group had higher rates of complications (44% vs 38%) and reoperations (30% vs 14%) than the FX group. Overall, men had higher rates of both complications (76% vs 33%) and reoperations (43% vs 19%) than women. Survival analysis for any reoperation at 4 years showed TEA for FX having higher survival (86%) than TEA for AX (70%). On multivariable analysis, only being male was associated with more complications, but the model was unstable because of low sample size. Almost one-half of TEA patients experienced complications and approximately one in four required reoperation within 4 years postop. Total elbow arthroplasty remains associated with substantial complication and reoperation rates. Surgical indication and gender may influence postoperative TEA outcomes. Prognosis IV.

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