SURVIVORSHIP, COMPLICATIONS, AND PATIENT-REPORTED OUTCOMES FOLLOWING DISCOVERY TOTAL ELBOW ARTHROPLASTY

Total elbow replacement (TER) is an established treatment for end-stage elbow pathology; however, long-term outcome data remain limited due to relatively low procedural volumes. The Discovery Elbow system is widely used, but long-term clinical outcomes are not well described. This study aimed to evaluate implant survivorship, complications and patient-reported outcomes. This retrospective study included all TERs performed between 2011 and 2024 by three surgeons at a single tertiary referral centre. Patients were identified from prospectively coded operative records. Kaplan-Meier analysis was performed with revision as the end point and deaths censored. A total of 196 TER were included. Mean follow up was 23.2 months (range 0–144), and mean age at surgery was 66 years (range 22–86 years). Implant survivorship was 96% at 5 years and 90% at 10 years. Eighteen revision procedures were performed. The most common indication was aseptic loosening (n=7), followed by periprosthetic fracture (n=5) and infection (n=3), with three cases classified as other or unclear. Post-operative complications included infection in 4.6% n=9), periprosthetic fracture in 4.1% (n=8), and ulnar neuritis in 5.1% (n=10), with one patient (0.5%) requiring ulnar nerve transposition. Radiographic loosening was identified in 12.2% (n=24) of elbows, of which 3.6% (n=7) underwent revision for aseptic loosening. Patient reported outcome were available for 68 patients (44%). The mean QuickDash score was 42.1 (median 40.9, range 0–90.9) and the mean EQ-5D-5L index score was 0.63 (median 0.82, range −0.39 to 1.00), with a mean EQ-VAS of 65.9 (median 67, range 29–100). Mean pain score was 3/10 and satisfaction 9.7/10. Eighty-five percent returned to normal daily activities, and 89% would undergo surgery again. This study represents one of the largest series evaluating the Discovery Total Elbow system. The implant demonstrates good survivorship with a defined complication profile and high patient satisfaction.