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

ABSTRACT

BACKGROUND: The reported outcome of total elbow replacement is inferior to hip and knee arthroplasty, and there might be an element of institutional bias. METHODS: We analyzed the outcome of Souter and Coonrad-Morrey total elbow prosthesis in rheumatoid elbow performed by a single surgeon from a center independent from standpoint of being involved in the designing or manufacturing of the implant. RESULTS: We had 44 Souter elbows with a mean follow-up of 108 months and 55 Coonrad-Morrey elbows with mean follow-up of 60 months. The Mayo Elbow Performance Score was comparable in both the groups with similar subjective satisfaction. Souter elbow showed a survivorship of 92.9% at 5 years and 76% at 10 years, with aseptic loosening rate of 18% and instability of 9% as main reasons for the failure. The Coonrad-Morrey elbow shows 100% survival at mean follow-up of 5 years in our series. CONCLUSION: We find high rate of instability and loosening of Souter prosthesis with an inferior 5-year survival compared to Coonrad-Morrey prosthesis.