Distal humerus cortical strains following total elbow arthroplasty.

The aseptic loosening of total elbow replacements is a serious complication resulting in significant patient morbidity. It is thought to occur secondary to stress shielding of the distal humeral cortex by the stiff stem of the implant. Some total elbow prostheses incorporate an anterior flange intended to improve implant stability and peri-articular load transfer in an attempt to reduce this effect However, few studies have directly assessed the changes in cortical strains following total elbow arthroplasty or the biomechanical advantage of the anterior flange design.