A STUDY OF 31 SOUTER/STRATHCLYDE TOTAL ELBOW REPLACEMENTS OVER 10 YEARS

Abstract

Aim: The purpose of this study was to assess the outcome of total elbow replacement surgery by looking at pain, range of movements and functional improvement as well as immediate and delayed complications.

Methods: It is a retrospective study of medical and Nursing notes from June 1994 until November 2003. 32 elbow replacements were performed. However 1 set of notes were unrecoverable, therefore the study group was 31 elbow replacements on 22 people. 9 bilateral replacements. The range of follow up time was 5 months to 9.5 years. (Mean of 5 years). 3 patients (5 elbows) were deceased at the time of study. All except 3 of the elbows were replaced as a result of rheumatoid arthritis with a mean patient age of 67 years. ((range 41–84)

Results: 84% of patients were documented to have impaired activities of daily living (ADLs) pre-operatively. Average range of movement before surgery was 500 – 1250 (750).

All were operated on by the same surgeon. 6 elbow (19%) had a pre-discharge complication, 4 ulna nerve palsies and 2 superficial wound infections. No cases of proven deep prosthetic infection. 1 case of symptomatic loosening after 12–24 months, awaiting revision. 1 case of loosening seen on X-ray after 5 years, the patient is asymptomatic but still under follow up. 21 of the 22 patients reported to be very satisfied with the outcome with only 4 elbows not allowing improvement in ADLs. Documented range of movement improved on an average by 200 of extension and 110 of flexion.

Conclusion: The majority of elbow replacements were done for rheumatoid arthritis and the outcome has been very good with few lasting complications. The main pre-operative complains of inability to perform ADLs was greatly improved by the surgery. Documentation of range of movements and objective pain measurement was poor making this difficult to comment on.