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Primary Souter-Strathclyde total elbow prosthesis in rheumatoid arthritis
J C T van der Lugt1, R B Geskus, P M Rozing
1Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands. j.c.t.van_der_lugt@lumc.nl
The Journal of Bone and Joint Surgery. American Volume
|March 5, 2004
Summary
Total elbow replacement for rheumatoid arthritis shows a high complication rate, particularly humeral loosening. This suggests it may be best reserved for severely disabled patients.
Area of Science:
- Orthopedic surgery
- Rheumatology
- Biomedical engineering
Background:
- Total elbow arthroplasty is a recognized treatment for rheumatoid arthritis-related elbow pain.
- This study prospectively evaluates the Souter-Strathclyde total elbow prosthesis.
Purpose of the Study:
- To assess the outcomes and complications of the Souter-Strathclyde total elbow prosthesis in patients with rheumatoid arthritis.
- To identify factors associated with adverse outcomes.
Main Methods:
- A prospective study of 204 primary total elbow prostheses in 166 rheumatoid arthritis patients (June 1982–December 2000).
- Mean follow-up of 6.4 years, with regular clinical and radiographic examinations.
- Kaplan-Meier survival analysis was used to determine implant survival rates.
Main Results:
- High complication rates observed, including pain at rest, ulnar nerve paresthesias, and a significant association between pain/decreased function and humeral loosening.
- Twenty-four revisions were performed for various reasons, with humeral component loosening being a primary concern (10 cases).
- Implant survival rates were 77.4% at 10 years and 65.2% at 18 years.
Conclusions:
- Total elbow replacement is linked to a high complication rate, potentially limiting its use to severely disabled individuals.
- The Souter-Strathclyde prosthesis shows comparable results to other implants, but humeral component loosening remains a significant issue.