Treatment outcomes of periprosthetic fracture following unlinked total elbow arthroplasty: A case series study

OBJECTIVES: This study aimed to evaluate periprosthetic fracture management following unlinked total elbow arthroplasty (TEA) based on a retrospective case series analysis. METHODS: The medical records of 13 patients with periprosthetic fractures who underwent unlinked Kudo TEA at our institution between 2013 and 2022 were retrospectively reviewed. Postoperative assessment included elbow range of motion, radiographic evaluation, and the Mayo elbow performance score. RESULTS: Among the 13 patients, 11 were managed surgically, and two received conservative treatment. Seven patients with component loosening and insufficient bone stock underwent revision to a linked TEA. Three patients with isolated ulnar loosening but preserved bone stock underwent revision with a long-stemmed unlinked ulnar component. One patient was treated with internal fixation. At the latest follow-up, the mean total arc of elbow motion was 91°. The mean Mayo elbow performance score was 85. All cases of aseptic loosening were treated without using strut bone allografts. CONCLUSIONS: Unlinked Kudo TEA is an effective option for primary TEA, considering the possibility of future periprosthetic fractures, as revision procedures are more straightforward than those for linked TEA. When loosening is observed, early intervention is advised to reduce the risk of periprosthetic fractures.