Abstract
Introduction: The long term results of a previously published (J Shoulder Elbow Surg. 2002 Sep–Oct; 11(5):486–492) series of 44 primary Souter-Strathcyde total elbow arthroplasties performed on 36 patients with rheumatoid arthritis by a single surgeon in a district general hospital are presented.
Methods: Of the 36 patients 14 patients had died leaving 22 patients or 28 elbows that could be followed up with a mean follow up of 11 years (range 9.7–17.8 years). Patients were followed up in research clinics. They underwent plain radiographs and clinical examination. The notes of the deceased patients were reviewed.
Results: In the surviving patients 60% reported complete freedom of pain, 28% mild intermittent pain and 11% moderate pain. The mean range of motion at follow up was 91 degrees (range 30–130 degrees). This represented a mean gain of 15 degrees of flexion, but only a 1 degree gain in extension. Fourteen elbows had a range of motion of 100 degrees or greater compared with 9 before surgery.
In the deceased patients 2 patients had undergone revision and the remaining patients had died of causes unrelated to the surgery with the prosthesis intact. There was 1 permanent ulnar nerve palsy and two deep infections one requiring debridement. Eight of the original 44 primaries required revision, 3 for fractures and 5 for loosening.
Discussion: In patients with rheumatoid arthritis and low functional demand, the Souter-Strathclyde total elbow arthroplasty performs well in abolishing pain and increasing independence in carrying out the activities of daily living.
The abstracts were prepared by Major SA Adams. Correspondence should be addressed to Major M Butler, CSOS, Institute of Naval Medicine, Crescent Road, Alverstoke, Hants PO12 2DL
