This is a retrospective review of 80 Mayo and Coonrad total elbow arthroplasties in 72 patients at the Mayo Clinic from 1973 to 1977. Average follow-up was about four years (minimum two). It asks how well early constrained implants relieved pain and restored motion, and catalogs the complications of the procedure's early adoption.
When you see an elbow arthroplasty candidate, remember the core lesson of this series: pain relief is reliable, but fixation is fragile. The humeral component is the weak link, and two technical errors drive loosening. Fracturing a supracondylar column destroys the bone stock that anchors the implant, and poor cementing leaves gaps that permit micromotion.
The medial column is smaller and more vulnerable, so protect it during bone preparation. Match the prosthesis to the bone rather than removing bone to fit an oversized implant.
Patient selection matters as much as technique. Rheumatoid patients did well, but young, active post-traumatic patients stressed these constrained hinges and loosened more. That reasoning still steers us toward conservative options first in young patients and toward semiconstrained loose-hinge designs.
This paper also connects mechanics to failure: a rigid hinge cannot dissipate elbow loads that reach three times body weight, so the force lands on the bone-cement interface. That insight is why modern implants are semiconstrained and why meticulous soft-tissue preservation is emphasized.
This is a retrospective review of 80 Mayo and Coonrad total elbow arthroplasties in 72 patients at the Mayo Clinic from 1973 to 1977. Average follow-up was about four years (minimum two). It asks how well early constrained implants relieved pain and restored motion, and catalogs the complications of the procedure's early adoption.
When you see an elbow arthroplasty candidate, remember the core lesson of this series: pain relief is reliable, but fixation is fragile. The humeral component is the weak link, and two technical errors drive loosening. Fracturing a supracondylar column destroys the bone stock that anchors the implant, and poor cementing leaves gaps that permit micromotion.
The medial column is smaller and more vulnerable, so protect it during bone preparation. Match the prosthesis to the bone rather than removing bone to fit an oversized implant.
Patient selection matters as much as technique. Rheumatoid patients did well, but young, active post-traumatic patients stressed these constrained hinges and loosened more. That reasoning still steers us toward conservative options first in young patients and toward semiconstrained loose-hinge designs.
This paper also connects mechanics to failure: a rigid hinge cannot dissipate elbow loads that reach three times body weight, so the force lands on the bone-cement interface. That insight is why modern implants are semiconstrained and why meticulous soft-tissue preservation is emphasized.