The effect of epidemiologic and intraoperative factors on survival of the standard Souter-Strathclyde total elbow arthroplasty

Previously published work has revealed an 87% survivorship after 12 years f or the standard Souter-Strathclyde total elbow arthroplasty in patients wit h rheumatoid arthritis. Of the 13% that were revised, 75% were due to loose ning of the humeral component. The aim of this research was to identify the specific epidemiologic and intraoperative factors that predisposed to this humeral loosening. Specifically, factors such as age, sex, radiologic stag ing of the disease, position of the implant in bone, and size of the implan t inserted were evaluated. After analysis of 186 cases, we concluded that t he position of the humeral component within the humerus is crucial for long -term survivorship. Specifically in the lateral plane, the stem should be a ligned in the plane of the humerus and the implant inserted to the correct depth. The articular surface of the implant should lie at the level of the normal trochlea. At the anteroposterior plane, the implant should sit centr ally and not be lateralized. We conclude that good surgical technique is cr ucial to the long-term effectiveness of this implant.