In vivo three-dimensional kinematics of total elbow arthroplasty using fluoroscopic imaging

Higher complication rates and lower survivorship are still seen for total elbow arthroplasties compared to total knee and hip arthroplasties. This is partly due to polyethylene wear of the articular surface induced by excessive articular contact stress during elbow motion. The aim of this study was to dynamically evaluate in vivo three-dimensional elbow motion after total elbow arthroplasty. Twelve patients (15 elbows) who underwent operation with the Osaka University Model Total Elbow System were analysed using X-ray fluoroscopic imaging and a two-dimensional/three-dimensional registration technique, which could accurately estimate the three-dimensional spatial position of components. Valgus/varus angle and rotation between humeral and ulnar components showed wide variations among patients. Elbows with valgus angle and internal rotation >10° could induce edge-loading of the articular surface. Component alignment, articular configuration, and soft-tissue balance can affect the kinematics of total elbow arthroplasty.