The Journal of Bone and Joint Surgery, Vol 71, Issue 2 217-222, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
Capitellocondylar total elbow replacement. A long-term follow-up study
AJ Weiland, AP Weiss, RP Wills and JR Moore
Department of Orthopaedic Surgery, Johns Hopkins University, School of Medicine, Baltimore, Maryland 21205.
The results of forty total elbow replacements in which a capitellocondylar
prosthesis was implanted in thirty-five patients (five of whom had a
bilateral procedure) were reviewed retrospectively. The average length of
follow-up was 7.2 years (range, four to twelve years). Pronation,
supination, and flexion of the elbow improved considerably, but extension
did not change a great deal. The average rating of the elbow, according to
the scoring system of Ewald et al., improved from 30 to 88 points, but the
functional score, as defined by the American Rheumatism Association,
improved in only four patients. Malarticulation or dislocation of the
prosthesis occurred in ten patients (29 per cent). In two other patients, a
deep infection developed, necessitating removal of the prosthesis. Ten
prostheses (ten patients) had radiolucent lines on follow-up radiographs,
but these lines were not associated with pain or loosening. Seven patients
(seven elbows) had a transient ulnar-nerve palsy. The incidence of this
complication was reduced from 30 per cent (five of seventeen patients) to
15 per cent (four of twenty-eight patients) when the lateral Kocher
approach to the elbow was adopted.
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