One-stage arthroplasty of the ipsilateral shoulder and elbow

Twenty 1-stage ipsilateral shoulder and elbow joint replacements were performed in 17 patients from 1988 to 1998 in the Nottingham Shoulder and Elbow Unit, Nottingham, England. There were 12 women and 5 men with a mean age at operation of 57 years. All 17 patients had rheumatoid arthritis. The indication for performing the 2 joint replacements in 1 stage was severe symptomatic involvement of both joints. The shoulder was replaced first, with the patient being repositioned and redraped for the elbow replacement. The follow-up averaged 5 years 2 months (range, 23 months to 13 years 8 months). All patients had significant pain relief and improvement in function, and 12 of the 15 patients reviewed would have been prepared to have the same procedure on the other side, if it became necessary (in 3, this had been done). The procedure offers major advantages because the number of anesthetics is reduced, it is more cost-effective, and it facilitates functional rehabilitation.