Elbow Arthroplasty - Fixation

Cementation
  • Components are fixed to bone with polymethylmethacrylate cement.
  • Advantages:
    • Allows prosthesis to fit perfectly to irregularities of bone.
    • Immediate stability allows for full activity post operatively
  • Disadvantages
    • If and when the prosthesis becomes loose, the loosened cement can grind away bone, leaving less bone stock available for revision surgery.

Porous Coating

  • Metal surfaces attaching to bone have a roughened surface coat
  • Coating may be made of metal, ceramic, polymers, or combination of all these materials
  • These materials are formed into beads, irregular particles, or etchings and applied to the prosthesis
  • Irregularity allows for increased surface area
  • All elbow prosthesis are cemented. Porous coating may be employed as an additional fixation method
Metal etching about distal humeral and proximal ulnar component

 Other

Flanged humeral components

The flange is built anteriorly, to grasp the humeral cortex and prevent posterior and torsional stresses at the humerus.

Side view of Coonrad-Morrey humeral component removed from patient. The flange is anterior (blue arrow). The distal stem has a coated metallic bead surface to increase surface area to facilitate fixation. Note residual cement remains (red arrows).

 

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