Radiological assessment of cementation following total elbow arthroplasty

Total Elbow Replacements are indicated for pain and disability in patients with rheumatoid and osteoarthritis of the elbow. The quality of the cementation has been specifically studied and shown to be directly related to the clinical outcome and implant survival. Aim The aim of our study is to radiologically assess and grade the cementation around the components following total elbow replacement (GSB 3 or Coonrad Morrey) in two groups of patients. Materials and methods Group I underwent total elbow replacement using Heraeus cement gun with medium palacos viscosity cement and group 2 using Zimmer cement gun with simplex medium viscosity cement. Average age in Group 1 was 72.3 (range 67–88 yrs) and group 2 was 69 years (range 52–87 yrs) 3 Coonrad Morrey and 13 GSB 3 total elbow replacement were used in Group 1 and 2 Coonrad Morrey and 14 GSB 3 in group 2. The primary indication for surgery was osteoarthritis, rheumatoid arthritis, post traumatic arthritis and seronegative arthritis in both groups. The cementation was assessed radiologically using three grading system (Morrey, Gerber & Bristol). Results In Group I (Heraeus) 14 had adequete cementation in both AP and lateral radiographs, 1 humeral and 1 ulna components on AP radiograph revealed marginal cementing. In Group 2 (Zimmer) 11 had adequete cementation in both AP and lateral radiographs, 1 humeral and 1 ulna on AP and 1 humerus and 3 ulna on lateral radiograph were 4 marginal. Conclusion Precise application of cement during total elbow arthroplasty is an important factor in achieving good implant fixation. To achieve this, a proper ergonomic design of the cement gun is mandatory. From our study we conclude that there was a difference in quality of cementation between the two groups.