SALVAGE OF FAILED UPPER LIMB ARTHROPLASTY WITH A LINKED SHOULDER AND ELBOW REPLACEMENT

Abstract

We report 5 cases of linked shoulder and elbow replacement (LSER) following failure of single-joint arthroplasty. Whilst total humeral replacement has been reported for treatment following resection for tumour we know of no reports of linked shoulder and elbow prostheses for arthropathy alone. Between May and December 2005, 2 patients with total elbow arthroplasty and 3 patients with total shoulder arthroplasty were revised to LSER for loosening of the long humeral stems or periprosthetic fracture. Custom-made prostheses were produced using computer-aided design and manufacture technology. There were no early complications including infection. All 5 patients reported early improvement of symptoms, with the ability to bear weight axially through the limb, restored. This technique avoids the problem of a stress riser between the stems of separate shoulder and elbow replacements and solves the problem of salvage of long-stemmed implants where no further humeral fixation is possible.