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Souter-Strathclyde total elbow arthroplasty
1Department of Orthopaedic Surgery, Leiden University Medical Centre, The Netherlands.
Insights
The Souter-Strathclyde elbow arthroplasty demonstrated a 69% survival rate at ten years. While pain relief was achieved in 67% at one year, long-term outcomes showed persistent pain in 64% of cases.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Reconstructive Surgery
Background:
- The Souter-Strathclyde elbow prosthesis was utilized between 1982 and 1993.
- A review of 66 consecutive implants in 59 patients was conducted.
Purpose of the Study:
- To evaluate the long-term outcomes and survival rates of the Souter-Strathclyde elbow arthroplasty.
- To assess pain relief, range of motion, and complication rates associated with this prosthesis.
Main Methods:
- Retrospective review of 66 Souter-Strathclyde elbow arthroplasties.
- Kaplan-Meier survival analysis.
- Assessment of pain, range of motion, and complications.
Main Results:
- The 10-year survival probability was 69%.
- Early complications included epicondyle fractures (9%) and ulnar neuropathy (33% post-op incidence).
- At one year, 67% experienced pain relief; after 10+ years, 36% were pain-free, with 64% reporting occasional pain.
Conclusions:
- The Souter-Strathclyde elbow prosthesis has a moderate long-term survival rate but is associated with significant rates of persistent pain and complications.
- Further research into improving elbow arthroplasty outcomes is warranted.
Abstract:
We have reviewed 66 consecutive Souter-Strathclyde arthroplasties of the elbow implanted in 59 patients between 1982 and 1993. Thirteen patients (15 elbows) (19.6%) died. Sixteen elbows (24.2%) were revised, six for aseptic loosening (9%), four (6%) because of fracture or loosening after a fracture, three (4.5%) for infection and three (4.5%) for dislocation. Four patients refused to attend for review. In 33 elbows with a follow-up of 93 months (60 to 167) complete relief of pain was achieved in 22 (67%) when seen at one year. After ten years or more 36% of the elbows were painfree and 64% had occasional slight pain especially under loading or stress. The mean gain in the arc of movement was 16 degrees, but a mean flexion contracture of 33 degrees remained. The main early complications were intraoperative fractures of the epicondyles (9%), postoperative dislocation (4.5%) and ulnar neuropathy. The incidence of ulnar neuropathy before operation was 19%. After operation 20 patients (33%) had an ulnar neuropathy, in seven of which it had been present before operation, and of these weakness of the hypothenar muscle occurred in two. The probability of survival of the Souter-Strathclyde elbow prosthesis based on the Kaplan-Meier calculation is 69% at ten years.