The Journal of Bone and Joint Surgery, Vol 74, Issue 1 95-100, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
Capitellocondylar total elbow replacement. A long-term follow-up study
JT Ruth and AH Wilde
Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Ohio.
Fifty-one capitellocondylar elbow replacements were inserted in forty-one
patients between 1976 and 1986. Thirty-nine patients had rheumatoid
arthritis and two had traumatic osteoarthrosis. The average age of the
patients at the time of the operation was fifty-six years (range,
twenty-one to seventy-seven years). Thirty-one patients who had thirty-nine
retained elbow prostheses had an average length of follow-up of 6.5 years
(range, two to thirteen years). Flexion improved an average of 20 degrees;
extension, 4 degrees; pronation, 22 degrees; and supination, 36 degrees.
Relief of pain was complete in 85 per cent of the thirty-nine elbows, and
in 15 per cent there was only mild pain. Noteworthy postoperative
complications in the original fifty-one elbows included infection in four
elbows (8 per cent), dislocation in three (6 per cent), and ulnar
neuropathy in sixteen (31 per cent). Three elbows were revised: one for a
humeral fracture, one for recurrent dislocation, and one for aseptic
loosening. Aseptic loosening was evident on radiographs of two elbows; one
patient was completely asymptomatic, and one had mild pain with deformity.
The Souter zonal radiographic assessment system for identification of
radiolucencies at the bone-cement interface was utilized; there was no
significant difference in radiolucencies between ulnar components backed
with metal and those that were not backed with metal. Kaplan-Meier
cumulative survivorship analysis demonstrated that a functional prosthesis
was retained in 88 per cent of the elbows at 1.4 years postoperatively and
in 83 per cent at 5.5 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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