Posterior Flange Cyclic Loading in a Novel Total Elbow Arthroplasty.

Purpose: The goal of this study was to test the static and dynamic strength and loosening resistance of the posterior flange of a novel total elbow arthroplasty. We also examined the forces experienced by the ulnohumeral joint and the posterior olecranon during expected elbow use. Methods: Static stress analysis was performed for 3 flange sizes. Failure testing was conducted on 5 flanges (1 medium size and 4 small sizes). Loading occurred to reach 10,000 cycles. If this was accomplished, the cyclic load was increased until failure occurred. If failure occurred before 10,000 cycles, a lower force was employed. The safety factor for each implant size was calculated, and implant failure or loosening was observed. Results: Static testing revealed a safety factor of 6.6, 5.74, and 4.53 for the small, medium, and large flanges, respectively. The medium-sized flange completed 10,000 cycles with 1,000 N at 1 Hz, and then the force was increased until it failed at 23,000 cycles. Two small-sized flanges failed at 2,345 and 2,453 cycles, respectively, when loaded with 1,000 N. Two more small flanges were loaded with 729 N for 10,000 cycles, and then the cyclic load was continued until they failed at 17,000 and 17,340 cycles, respectively. No screw loosening was noted in any specimens. Conclusions: This study demonstrates that the posterior flange withstood static and dynamic forces greater than what is expected during in vivo use of a novel total elbow arthroplasty design. Static strength calculation and cyclic loading demonstrate that the medium-sized posterior flange is stronger than the small-sized posterior flange. Clinical Relevance: Ensuring that the ulnar body component and the posterior flange maintain secure connectivity with the polyethylene wear component may be beneficial to the proper function of a novel nonmechanically linked total elbow arthroplasty.