Abstract
From 1985 to 1998 we used the Souter implant for elbow replacement in the rheumatoid population. We have followed this cohort prospectively, and present simple outcome measures including initial pain relief, early complication rates, radiological changes with time, and survivorship.
We performed 71 Souter elbow replacements in 62 rheumatoid patients (51 female, 11 male). The average age at surgery was 61 (range 38–79). All patients had end stage arthropathy. Early results and complications were assessed in all patients. Subsequently, ten cases were revised for loosening, and eight patients (10 elbows) died before recent follow up, leaving 51 cases for long term study. Clinical and radiological data were obtained.
On early follow up, 94% had no or minimal pain. Thirty-one percent suffered a complication. Overall, 18% cases had ulnar nerve problems and 7% dislocated in the first year. Seven percent had wound problems, including two deep infections. At mean long term follow up of 6 years (range: 2–15 years) there were high rates of satisfaction in patients with retained prostheses. Progressive radiolucency around the humeral component was common and treated expectantly. Late instability was not seen. Pain relief was maintained.
There have been few long-term reports on the Souter elbow replacement. This group of patients from a single centre has been followed prospectively. Infection and ulnar nerve complications are comparable with other series, and are less related to prosthesis. The rate of humeral component loosening in this series is high. The rate of dislocation, however, is low. This prosthesis sacrifices stability to transmit forces through the soft tissues. Although stability is acceptable there is no beneficial reduction in loosening.
The abstracts were prepared by Mr Roger Emery. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN
