Long-term survival of the Souter-Strathclyde total elbow replacement in patients with rheumatoid arthritis

• Published in: Journal of bone and joint surgery. British volume Vol. 92; no. 5; pp. 656 - 660
• Main Authors: IKÄVALKO, M, TIIHONEN, R, SKYTTÄ, E. T, BELT, E. A
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.05.2010
• Subjects: Adult; Aged; Aged, 80 and over; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - surgery; Arthroplasty, Replacement - instrumentation; Biological and medical sciences; Biomechanical Phenomena; Diseases of the osteoarticular system; Elbow Joint; Female; Humans; Inflammatory joint diseases; Joint Prosthesis - standards; Joint Prosthesis - statistics & numerical data; Male; Medical sciences; Middle Aged; Orthopedic surgery; Polyethylene - adverse effects; Prosthesis Design; Prosthesis Failure; Reoperation - statistics & numerical data; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Survival Analysis; Treatment Outcome; Young Adult; Human; Immunopathology; Prognosis; Diseases of the osteoarticular system; Autoimmune disease; Inflammatory joint disease; Long term; Survival; Chronic; Orthopedic surgery; Treatment; Rheumatoid arthritis; Elbow
• ISSN: 0301-620X; 2044-5377
• DOI: 10.1302/0301-620X.92B5.22613

Between 1982 and 1997, 403 consecutive patients (522 elbows) with rheumatoid arthritis underwent Souter-Strathclyde total elbow replacement. By the end of 2007, there had been 66 revisions for aseptic loosening in 60 patients. The mean time of follow-up was 10.6 years (0 to 25) The survival rates at five-, ten, 15 and 19 years were 96% (95%, confidence interval (CI) 95 to 98), 89% (95% CI 86 to 92), 83% (95% CI 78 to 87), and 77% (95% CI 69 to 85), respectively. The small and medium-sized short-stemmed primary humeral components had a 5.6-fold and 3.6-fold risk of revision for aseptic loosening respectively, compared to the medium-sized long-stemmed component. The small and medium-sized all-polyethylene ulnar components had respectively a 28.2-fold and 8.4-fold risk of revision for aseptic loosening, compared to the metal-backed ulnar components. The use of retentive ulnar components was not associated with an increased risk of aseptic loosening compared to non-retentive implants.