Abstract
This paper describes the design process leading to a total elbow replacement with components which have an accurate anatomical shape and require minimal bone resection. This allows a ‘modular’ approach to elbow reconstruction, i.e., radial head replacement alone, humeral hemiarthroplasty, humero-radial or ulnar replacement, or total (three component) reconstruction. This approach means that the surgeon may choose to replace only the damaged joint surfaces, rather than being committed to total replacement.
The parallel development of instruments for accurate bone forming is also described, allowing firm and precise fixation of prosthetic components without bone cement, a necessity for interlocking bone ingrowth to occur without extended immobilization.
A clinical trial of these components, in more than fifty patients for periods up to five years, is reviewed, showing the restoration of pain-free stability and greater ranges of motion than have been reported for other elbow replacement devices, and with no incidence of prosthetic removal caused by painful loosening.
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