Review of bone deficiency in total elbow arthroplasty revision

Total elbow arthroplasty revision rates have been increasing over time due to the increasing use of the procedure with the accompanying increase in complications. The most common complications that typically require revision surgery include aseptic loosening, periprosthetic fractures, infection, and component failure. The associated instability has an overall revision rate reported to be as high as 13%. One important factor when performing a revision surgery is bone quality and bone loss; this represents a challenge during the clinical decision-making process. Currently, there are several strategies used to address bone loss such as arthrodesis, resection arthroplasty, impaction grafting, allograft-prosthetic composite reconstruction, and custom prostheses. The aim of this review article is to provide a comprehensive review of the current strategies to improve diagnosis of failed total elbow arthroplasty and improve management and outcomes of this patient population.