Kudo total elbow arthroplasty in patients with rheumatoid arthritis - A long-term follow-up study

Background: Improvements in the design of total elbow prostheses over the l ast two decades have led to better and more consistent results. The type-3 Kudo total elbow prosthesis was developed in 1980. The long-term results of use of this implant have not been reported. Because it is an unlinked pros thesis, it is not known whether preservation of the anterior oblique compon ent of the ulnar collateral ligament at the time of implantation is importa nt. Methods: A type-3 Kudo total elbow arthroplasty with cement was performed i n forty-seven patients (fifty elbows) with rheumatoid arthritis. Revision r ates, clinical symptoms, postoperative complications, and radiographic chan ges were assessed. eleven to sixteen years (mean, thirteen years) postopera tively. Results: The overall survival rate of the prosthesis was 90% at sixteen yea rs. The mean Mayo elbow performance scores were all poor (mean overall scor e, 43 points) initially. The overall score was substantially improved at bo th the intermediate follow-up examination (four to six years after the oper ation) and the late follow-up examination (eleven to sixteen years after th e operation) to 81 and 77 points, respectively. The overall rate of radiolu cency about the humeral component was 45% at the intermediate follow-up exa mination and 100% at the long-term follow-up examination. The rate of radio lucency about the ulnar component at the intermediate and late follow-up ex aminations was 4.3% and 8.9%, respectively. No great differences in results were found with preservation of the anterior oblique component of the ulna r collateral ligament. Conclusions: This long-term follow-up study showed acceptable results of th e type-3 Kudo total elbow arthroplasty in patients with rheumatoid arthriti s. Preservation of the ulnar collateral ligament does not seem to be necess ary when performing this procedure.