Souter-Strathclyde total elbow arthroplasty in rheumatoid arthritis

Abstract

We present the outcome of 47 Souter-Strathclyde replacements of the elbow with a mean follow-up of 82 months (12 to 129). The clinical results were assessed using a condition-specific outcome measure. The mean total score (maximum 100) before the operation was 47.21 and improved to 79.92 (p < 0.001). The mean pain score (maximum 50) improved from 21.41 to 46.70 (p < 0.001) and the mean functional component of the score (maximum 30) from 11.19 to 18.65 (p < 0.001). There was negligible change in the score for the range of movement although a significant improvement in mean flexion from 124 degrees to 136 degrees was noted (p < 0.001). Revision surgery was required in four patients, for dislocation, wound dehiscence and early infection in one, late infection in two and aseptic loosening in one. The cumulative survival was 75% at nine years for all causes of failure and 97% at ten years for aseptic loosening alone. Our study demonstrates the value of the Souter-Strathclyde total elbow arthroplasty in providing relief from pain and functional improvement in rheumatoid patients.

Complications of total elbow replacement: A systematic review

“…Over the last 20 years, there has been increasing popularity of TEA due to improvements in surgical technique and 35 15 IV Schneeberger et al, 1997 68 41 12 IV Schneeberger et al, 2000 69 14 10 IV Schneeberger et al, 2007 70 19 10 IV Shi et al 71 37 11 IV Sj€ od en et al 73 19 10 IV (continued) 22 (Table II). New prosthetic designs and improved surgical techniques are most likely responsible for this positive change.…”

Outcome of total elbow replacement for rheumatoid arthritis: Single surgeon's series with Souter-Strathclyde and Coonrad-Morrey prosthesis

“…We have found an improvement in elbow flexion by 42.1 compared to preoperative status; but, there was no improvement in the extension, which is consistent with the literature evidence. 6,10,19,20 In patients who were clinically reviewed, when we considered patients who have survived a revision surgery the percentage of excellent to good results according to MEPS are 88% at a range of follow-up from 66 to162 months. When we include as poor results the 7 elbows that had revision surgery and the 1 that was removed because of infection, then the percentage of excellent to good results drops to 66.7%.…”

“…When we also considered patients with loosening and instability who refused to have revision surgery as failures, our survival figures dropped to 76% at 10 years, which is very much consistent with the published literature evidence. 6,10,19,20 The subjective satisfaction rate among patients who are currently alive was 100%, including patients who had revision and implant removal.…”

“…There is literature evidence from independent centers on the long-term follow-up results of this prosthesis when used for rheumatoid elbows. 3,6,10,19,20 Coonrad-Morrey prosthesis (Zimmer,Warsaw, IN) is a semi-linked prosthesis with long-term published results when used for rheumatoid elbows 11,13 and distal humeral fractures. 4,14,16 The senior author has been performing total elbow replacements from 1993, and these patients were also being followed up.…”

The History and Future of Unlinked Total Elbow Arthroplasty

“…The prosthesis is unlinked but has a relatively constrained design. 9 Instability of this implant has been less frequent than that of other unlinked designs; however, loosening of the shortstemmed humeral component has a 3.6-to 5.6-fold risk of revision for aseptic loosening compared to the longstemmed humeral components. 10 The Kudo total elbow arthroplasty was introduced in 1972.…”