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A COMPARATIVE STUDY OF THE SURVI-VORSHIP OF THE SOUTER-STRATHCLYDE TOTAL ELBOW ARTHROPLASTY IN RHEUMATOID ARTHRITIS PATIENTS UNDER AND ABOVE 50 YEARS OF AGE



Abstract

Our study examines a group of patients less than fifty years of age who underwent Total Elbow Arthroplasty with the Souter Strathclyde Elbow Replacement and compares their survivorship with a dataset of older group of patients.

309 patients were who underwent standard long stemmed Souter Implants as a primary procedure for rheumatoid arthritis over the last 16 years were included in this study. Patients were divided into two groups according to the their age at the time of surgery. In the first group of older patients greater than or equal to 50 years of age (Mean Age =64.4 years) there were 263 patients with a mean follow up of 7.3 years. The second group consisted of patients less than 50 years of age (Mean Age 42.04 years) who had a longer mean follow up period of 9.3 years. The survivorship of the implants for three different failure events was compared for both groups. The radiographs were evaluated using the Kaplan-Meir survival analyses, to produce survival curves for revision, revision due to aseptic loosening of the humeral component and finally gross loosening of the humeral implant (Hidex> 1). For each terminal event there were two curves and the age group analyses were all non-significant when log rank tested. The rates of loosening/revision were comparable in all curves.

We set out to determine the role of age as predictive factor for loosening. Our conclusions were that Total Elbow Arthroplasty is suitable for younger patients with rheumatoid elbow. Using survivorship data there does not appear to be any difference in loosening when compared to patients of an older age group. As previously published the position of the humeral component within the humerus is crucial for long-term survivorship. Thus age alone should not be the sole discretionary factor for withholding the benefits of elbow Arthroplasty in younger patients.

Correspondence should be addressed to BESS c/o BOA, 35-43 Lincoln’s Inn Fields, London WC2A 3PE