Thirty capitellocondylar unhinged implant arthroplasties were performed on 27 patients during the period from October 1976 through June 1981. The average patient age was 59.4 years, with a preoperative diagnosis of rheumatoid arthritis in 28 elbows and osteoarthritis in two elbows. Follow-up periods averaged 39.9 months (range, 10-62 months). The indications for elbow arthroplasty were intractable pain, joint instability, failed synovectomy, or bilateral limitation of motion. Range of motion evaluations showed moderate increases in flexion, pronation, and supination after operation, although there was no significant improvement in extension. Ewald functional evaluation scores improved significantly from a mean of eight points prior to operation to a postoperative mean of 85 points. The significant complications occurring were deep wound infections, necessitating removal of the prosthesis (6.6%), and subluxation (13.2%), which responded to conservative treatment by long-arm casting. One patient required reconstruction of the medial collateral ligament for subluxation. Ulnar nerve paresthesia developed in 10% of the patients. One patient required neurolysis and transposition of the nerve for relief of symptoms. The posterolateral approach was adopted to reduce the incidence of ulnar nerve complications.
ASJC Scopus subject areas
- Orthopedics and Sports Medicine