Background: Recognition of total elbow arthroplasties (TEAs) on plain radiographs is difficult due to a multitude of
different types and models. Especially if surgery reports and documentation are not available, lost or when the primary
surgery was performed in another hospital the prosthesis type may be undeterminable. Therefore we investigated
in this platform study if a flowchart aids in recognition of thirteen different total elbow arthroplasty models on plain
Methods: An online questionnaire on the Shoulder and Elbow Platform was developed. Plain radiographs of thirteen
TEA models were shown with and without the help of an especially developed flowchart describing distinguishing
Results: Ten orthopedic surgeons specialized in upper extremity surgery completed the study. Recognition rates of the
thirteen total elbow arthroplasty models ranged between 20 and 100 percent without the flowchart. Using the flowchart
recognition varied between 40 and 90 percent. The recognition rates with the flowchart were not significantly higher.
Inter-observer reliability did not increase on a significant level.
Conclusion: Correct recognition of total elbow arthroplasty models with plain radiographs remains imperfect with our
developed flowchart. The flowchart increased correct recognition rates and inter-observer reliability.
Level of evidence: II