History and Evolution of Elbow Arthroplasties

Historically, rheumatoid arthritis represents the typical indication for elbow arthroplasty. Indications have been extended to include primary osteoarthritis, post-traumatic arthritis, and acute distal humerus fractures. Before the introduction of elbow arthroplasty, there were many surgical procedures, such as the interposition arthroplasty described for the first time by Schüller in 1893. Elbow arthroplasty was mainly developed as a response to the high failure rate of these procedures. The first prosthetic replacement was described by Robineau in 1925. Over the years, the prosthesis has continued to evolve in the attempt to optimize this treatment in order to avoid complications, like loosening and instability, and to achieve better postoperative outcomes. In response to these failures, three design concepts have been developed: linked or semi-constrained, unlinked, and convertible prosthesis. Radial head arthroplasty, described for the first time in the 1940s, had remarkable improvements and is nowadays recommended for comminuted radial head fractures. Despite the evolution of elbow arthroplasty designs, concerns regarding loosening in the long term, and in younger patients with high demands, are still present