Souter-Strathclyde elbow replacement for severe rheumatoid arthritis

Abstract

Twenty Souter-Strathclyde elbow replacements were performed for severe rheumatoid arthritis in 15 patients. They were followed-up for an average of 43 (range 26-63) months. While there was-severe pain in every elbow before the operation, 16 elbows were pain free and four elbows had mild pain at final follow-up. All elbows were unstable before surgery, especially in five elbows with 'fork and knife' deformity. However, there was only one dislocation at final follow-up. For the range of motion, flexion improved by an average of 21°, supination improved by an average of 7°and pronation improved by an average of 17°. There was an average loss of extension by 7°. The Mayo Clinic Performance Index improved from 30 points before the operation to 88 points at final follow-up. Complications affected nine elbows. One elbow was revised due to humeral loosening. It was related to a postoperative fracture of the supracondylar ridge after the use of a standard humeral component. A long-stemmed humeral component should be used primarily if the integrity of the supracondylar ridge is doubtful.