Total replacement of the rheumatoid elbow with a hingeless prosthesis

Twenty-four elbows with rheumatoid arthritis underwent total replacement arthroplasty with insertion of a hingeless surface-replacement prosthesis. These were followed for an average of three years and ten months. Excellent results were seen in fourteen elbows; fair, in seven; and poor, in three. Satisfactory pain relief as well as good stability were obtained in all but one elbow. Two elbows did not regain a useful range of motion. Proximal migration of the humeral component was seen in one elbow, and persistent subluxation with pain and instability was seen in another. No other major complications were encountered. The very low incidence of loosening in this series seems to substantiate the sound principle of the use of this type of hingeless prosthesis.