Survivorship and radiological analysis of the standard Souter-Strathclyde total elbow arthroplasty

We undertook a radiological analysis of 186 standard Souter implants to det ermine survivorship and to analyse the pattern of failure in those needing revision. The implants had been inserted as a primary procedure in patients with rheumatoid arthritis of the elbow at our hospital over the last 12 ye ars. Taking revision as an endpoint, the survivorship after 12 years was 87%, If , however, revision and loosening, defined as the Hinder value equivalent t o demarcation of 1 mm around the whole implant, are also included, the surv ivorship falls to 80%, Of the 24 implants revised, 18 (75%) were for proble ms with the humeral component, three (12.5%) with the ulnar component and t hree (12.5%) for instability. Loosening of the humeral, component occurred when the implant extended into the humerus, with the tip moving anteriorly on to the anterior humeral cor tex, Our study indicates that loosening can be predicted by the rate of cha nge in this angle of extension of the prosthesis.