SOUTER-STRATHCLYDE ELBOW REPLACEMENT FOR SEVERE RHEUMATOID-ARTHRITIS

Twenty Souter-Strathclyde elbow replacements were performed for severe rheumatoid arthritis in 15 patients. They were followed-up for an ave rage 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 h ad mild pain at final follow-up. All elbows were unstable before surge ry, 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 degrees, supination impro ved by an average of 7 degrees and pronation improved by an average of 17 degrees. There was an average loss of extension by 7 degrees. The Mayo Clinic Performance Index improved from 30 points before the opera tion to 88 points at final follow-up. Complications affected nine elbo ws. 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 b e used primarily if the integrity of the supracondylar ridge is doubtf ul.