ArticleJournal of shoulder and elbow arthroplasty2026
Short- to mid-term clinical outcomes and survivorship of the Nexel total elbow arthroplasty in Japanese patients: a single-center retrospective study.
Article in Journal of shoulder and elbow arthroplasty, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Total elbow arthroplasty (TEA) has become a well-established surgical option for advanced elbow disorders. The Nexel prosthesis (Zimmer Biomet, Warsaw, IN, USA) has been associated with mechanical complications and implant instability in previous international reports. However, no clinical outcomes have been published for Japanese patients. This study aims to evaluate the short- to mid-term clinical outcomes of the Nexel TEA in a Japanese cohort. Methods: We retrospectively reviewed 31 elbows in 30 patients (6 men, 24 women; mean age 73.0 years) treated with the Nexel prosthesis between 2015 and 2023, with a minimum follow-up of 24 months (mean 47.4 months). Primary diagnoses included rheumatoid arthritis (n = 9), fracture (n = 19), and osteoarthritis (n = 3) with some overlap. Clinical outcomes were assessed using the Mayo Elbow Performance Score, range of motion, and complication incidence. Results: The mean post-operative Mayo Elbow Performance Score was 79.3 points, reflecting generally favorable outcomes. Mean range of motion values were flexion 125.9°, extension -16.9°, pronation 76.5°, and supination 71.7°. Complications comprised aseptic loosening in 2 elbows, a periprosthetic olecranon fracture in 1, transient radial nerve palsy in 1, superficial infection in 3, and heterotopic ossification in 1. Most complications were managed successfully either conservatively or with minor revision. Conclusion: Despite prior concerns regarding early mechanical failure of the Nexel prosthesis, the present series demonstrates stable and satisfactory short- to mid-term outcomes in a Japanese patient population characterized by a high incidence of fracture indications and predominantly elderly, low-demand patients. These results may reflect careful surgical technique (including routine olecranon tip osteotomy to avert anterior flange impingement) and strict post-operative load-restriction protocols. Ongoing long-term follow-up and multicenter Japanese studies are required to confirm implant durability.
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