A review of the New Zealand National Joint Registry to evaluate the survivorship and revision rates of Nexel and Coonrad-Morrey total elbow arthroplasty

Background: Total elbow arthroplasty (TEA) is an appropriate surgical treatment option for a variety of conditions ranging from inflammatory arthritis to trauma. Because of a high complication profile, implant companies have attempted to improve patient outcomes with evolving design mechanics and philosophy. However, the Nexel TEA prosthesis has been criticized for its unacceptably high revision rate by other research groups in the literature. The purpose of this study was to evaluate the survivorship and revision rates of the Nexel and Coonrad-Morrey TEA implant systems in New Zealand. Methods: Prospectively collected National Joint Registry data were used to compare the survival rates of these prostheses. Underlying diagnoses, reasons for revision, and patient demographics were all recorded. Statistical analysis included survival analysis using KaplanMeier curves and comparison between groups using independent t tests. Results: Over the 23-year study interval, the Nexel and Coonrad-Morrey prostheses showed similar survivorship and revision rates. The revision rates at 5 years were 7.3% for Nexel and 4.5% for the Coonrad-Morrey cohorts. The average time to revision for those who are revised was 3.13 +/- 1.74 years in the Nexel group and 4.93 +/- 4.13 years in the Coonrad-Morrey population. Conclusion: Our study confirms a lower revision rate of the Nexel TEA compared to other studies in the literature. Additionally, the Nexel TEA implant performs comparably to its predecessor, the Coonrad-Morrey prosthesis in New Zealand. Although it is difficult to explain the discrepancy in results with the study by Morrey et al, future studies should focus on investigating postoperative radiographs and a deep analysis of the specific surgical technique used for this implant. Level of evidence: Level III; Retrospective Cohort Comparison using Large Database; Treatment Study (c) 2024 The Author(s). This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).