title: Mid-term outcome of total elbow replacement for rheumatoid arthritis.
abstract: To review the outcome of total elbow replacement (TER) in 21 patients after a mean of 64 months.
  
  
  
  Records of 12 women and 9 men aged 32 to 78 (mean, 59.1) years who underwent 22 TERs for rheumatoid arthritis by a single surgeon were reviewed. Functional outcome was assessed using the disability of the arm, shoulder and hand (DASH) questionnaire. The range of movement and Kaplan- Meier survival curve was determined. Adequacy of cementation was assessed on immediate postoperative radiographs. Aseptic loosening was assessed on radiographs using the Mayo clinic scoring system.
  
  
  
  After a mean follow-up of 64 (range, 10-145) months, the mean DASH score improved from 72.3 to 46.8, mean flexion improved from 96.9º to 128.1º, and mean extension lag from 37.3º to 24.0º. The 5-year survival rate with symptomatic aseptic loosening as the end point was 100%, and the revision rate for all reasons was 69%. Cement mantle was adequate in 17, marginal in 4 (most lacked cement around the prosthesis tip), and inadequate in one who was clinically asymptomatic. At the latest follow-up, 4 patients had a type-1 radiolucent line and one had a type-2 radiolucent line of both components; all remained clinically asymptomatic. Two patients developed transient radial nerve neuropraxia. One patient underwent revision for peri-operative fracture. One patient underwent a 2-stage revision for deep infection. One patient underwent revision for bilateral periprosthetic fracture. One patient underwent revision for symptomatic aseptic loosening. No patient had elbow dislocation.
  
  
  
  TER is a viable option for pain relief and functional improvement in patients with rheumatoid arthritis.
authors: Glan Clwyd Hospital, Rhyl, United Kingdom.
authors: H
authors: H
authors: Williams
authors: T
authors: T
authors: Madhusudhan
authors: A
authors: A
authors: Sinha
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D057929:Arthroplasty, Replacement, Elbow / Q000009:adverse effects; D001843:Bone Cements; D002484:Cementation; D004185:Disability Evaluation; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements
keywords: arthritis, rheumatoid; arthroplasty, replacement, elbow