Total elbow replacement (TEA) is used most often for patients over the age of 65 with moderate to severe elbow osteoarthritis (OA). These patients have tried many other forms of conservative care without success.
There are two basic types of TEAs: linked and unlinked. Unlinked means the two pieces (humeral and ulnar) are not hooked together. Unlinked implants are less likely to loosen. They rely on the surrounding soft tissues to hold them firmly in place.
If there is bone loss or soft-tissue deficiency, then maltracking or partial or complete dislocation can occur with the unlinked implants. Linked implants have some mechanical connection between the separate parts. This type of device allows more angle and rotation in the elbow.
The linked implants allow some amount of joint laxity (looseness). This feature permits the soft tissues to absorb stress on the joint. These loads would normally be translated to the implant-to-bone interface.
Studies show that linked devices last at least 10-years for most people. The unlinked system has a lower survival rate. Older adults with fewer loads and less activity are really the best candidates for either of these TEA systems. Younger, more active patients may put too much stress on the artificial joint causing fracture, loosening, or dislocation.