[Differential arthroplasty and endoprosthesis indications in rheumatoid arthritis of the elbow joint]

Abstract

Management of patients with rheumatoid arthritis of the elbow has changed significantly over the last several years. From a medical standpoint, the disease-modifying agents have decreased the number of patients requiring a synovectomy. When synovectomy is indicated, arthroscopic synovectomy has lessened the morbidity of this procedure, but the long-term effectiveness as a definitive reconstructive procedure has yet to be determined. Both coupled and uncoupled elbow joint replacements have emerged as reliable interventions for this diagnosis. Mayo's experience with 78 patients with rheumatoid arthritis undergoing total elbow arthroplasty has revealed a satisfactory outcome of approximately 92% at 12 years. The complication rate is approximately 15% consisting primarily of delayed avulsions or deficiency of the triceps tendon (2%), deep infection (2%), and ulnar nerve irritation (3%).