Thirty-four patients with an average age of 64 years had forty consecutive total elbow replacements done using Souter-Strathclyde prostheses between 1991 & 1994. Six patients had died, however useful data was available in three that were included in the series, two patients failed to attend review clinic due to other medical problems and were excluded from this study. The results of thirty-five elbows were analysed and are presented in this paper. Mean follow up at the final evaluation was 79 months.

All patients were evaluated before and after the operation using Modified Mayo’s Performance index with maximum score of 100. An independent observer performed the latest clinical evaluation.

The average score before the operation was 51. 4, this improved to 82. 4 (p< 0. 001), pain score (maximum 50) improved from 23. 4 before the operation to 47. 1 (p< 0. 001) and the functional component of the score (maximum 30) also improved from 12. 5 to 18. 57 at the time of follow up. The range of motion score (maximum 20) showed least improvement with slight improvement in flexion from 127. 57 before the operation to 134. 34 (p=0. 387) at the time of last follow up.

Four elbows were removed, one due to early and three due to late onset deep infection; there has been no incidence of aseptic loosening requiring revision. Other complications were ulnar nerve dysthesia (two), minor intra-operative fracture (two), dislocation (one).

The Souter-Strathclyde elbow provides sustained pain relief, and functional improvement in the upper extremity. Motion remains unaffected, with some improvement in flexion. We believe that the Souter-Strathclyde elbow replacement can help patients with rheumatoid elbow disease, and we continue to evaluate prospectively a larger series of patients.