Radial nerve palsy after humeral revision in total elbow arthroplasty

Hypothesis: The Mayo Clinic database was queried for all humeral component revision elbow arthroplasties complicated by radial nerve palsy.

Materials and methods: Multiple variables were analyzed to determine their impact on patient outcomes.

Results: Of 258 humeral component revisions, 7 (2.7%) were complicated by radial nerve palsy. The mean follow-up was 84 months (range, 24-233 months). Only 3 of 7 patients (43%) regained function. There was no recovery in 4 out of the 5 patients in whom power instruments or ultrasound was used for cement removal. Two of three patients who underwent exposure of the radial nerve had return of function at most recent follow-up.

Conclusions: Radial nerve palsy is an uncommon complication after humeral revision in total elbow arthroplasty but is not necessarily associated with full recovery. Return of function is less likely when power instruments or ultrasound is used for cement removal. Formal exposure and protection of the radial nerve are predictive of recovery.