A case of neuropathic arthropathy of the elbow with early loosening after total elbow arthroplasty.

Abstract

We reported the case of a 65-year-old woman who presented with neuropathic arthropathy of the elbow and had undergone cervical spinal cord tumour resection at 32 years of age. Open synovectomy with free-body resection was performed; however, the instability of the elbow joint rapidly progressed. Therefore, we performed total elbow arthroplasty (TEA) using a linked-type prosthesis. However, the humeral stem became severely loosened 1 year after arthroplasty. Furthermore, a periprosthetic humeral fracture developed due to a minor trauma. A revision TEA using a long-stem prosthesis was performed 4 years after the primary TEA. Radiographs taken 2 years after the revision surgery showed no evidence of implant loosening. In this case, early postoperative loosening occurred despite the use of a linked-type prosthesis and an appropriate cementing technique, suggesting that normal implants may not provide sufficient fixation for neuropathic arthropathy of the elbow. Since surgery for neuropathic arthropathy generally has a poor prognosis, surgical interventions including TEA should be carefully considered.