Total elbow arthroplasty in rheumatoid arthritis

Figures & data

Table 1. Trends in total elbow arthroplasty (TEA) for rheumatoid arthritis in one hospital specialized in the treatment of rheumatoid arthritis and in 19 other hospitals in Finland during 1982–2006

	Specialized hospital	Other hospitals
Mean follow-up (SD)	6.3 (4.3)	8.8 (5.0)
Total number of TEAs	776	681
TEAs during 1982–1993	295	102
TEAs during 1994–2006	460	578
NESimplant/Norway	27	36
Coonrad-Morrey	0	164
i.B.P./Kudo	0	218
Souter-Strathclyde	712	200

Table 2. Different prosthesis designs used in total elbow arthroplasty for rheumatoid arthritis from 1982 through 2006

Implant	n	Concept	Mean age	Women	Implantation period	Number of hospitals	Operations per hospital (range)
NESimplant/Norway	63	Unconstrained, humero-ulnar relationship realigned	60	86%	1997–2006	4	11 (4–15)
Coonrad-Morrey	164	Linked, semicontrained “sloppy” hinge	63	92%	1995–2006	14	10 (1–58)
i.B.P./Kudo	218	Unconstrained, anatomic humero-ulnar relationship	60	79%	1994–2006	13	16 (1–56)
Souter-Strathclyde	912	Unconstrained, humero-ulnar relationship realigned	58	87%	1982–2006	12	75 (1–697)^a

^a 78% of the Souter-Strathclyde total elbow arthroplasties were performed in one hospital specialized in the treatment of rheumatoid arthritis.

Table 3. Implants used for total elbow arthroplasty in rheumatoid arthritis in Finland from 1982 through 2006 and their inclusion in the study

Brand of implant	n	Inclusion in analysis	Used during years
Souter-Strathclyde	912	Yes	1982–2006
Kudo	175	Yes	1994–2003
Coonrad-Morrey	164	Yes	1995–2006
i.B.P.	43	Yes	2001–2006
Norway	13	Yes	1997–1998
Pritchard-Walker Mark II	20	No	1987–1998
NESimplant	50	Yes	2003–2006
Discovery	52	No	2003–2006
Other	1	No	1982
Total	1,345

Figure 1. Cox-adjusted cumulative survival of TEAs for rheumatoid arthritis in one hospital specialized in the treatment of rheumatoid arthritis (n = 776) and in 19 other hospitals (n = 681) in Finland from 1982 through 2006. The endpoint was defined as revision for any reason. Adjustment was made for age, sex, and prosthesis design.

Figure 2. Cox-adjusted cumulative survival of different prosthesis designs used in TEA for rheumatoid arthritis in Finland from 1982 through 2006. The endpoint was defined as revision for any reason. Adjustment was made for age and sex.

Table 4. Cox-adjusted survival of different total elbow replacement designs used in patients with rheumatoid arthritis from 1982 through 2006 in Finland

A	B	C	D	E	F	G	H	I	J	K	L	M
NES/Norway	63	3.5 (0–10)	29	92 (85–100)	0	–	0	–	0	–	1.1 (0.4–2.7)	0.9
Coonrad-Morrey	164	4.6 (0–10)	108	96 (92–99)	36	89 (83–96)	3	–	0	–	0.7 (0.3–1.3)	0.2
i.B.P./Kudo	218	6.5 (0–13)	173	93 (90–97)	110	89 (84–94)	46	83 (76–90)	0	–	0.9 (0.3–1.3)	0.5
Souter-Strathclyde	912	8.8 (0–25)	771	93 (91–94)	612	88 (86–90)	419	82 (80–85)	97	75 (70–79)	1.0	–

A Brand of implant

B n

C Mean follow (range), years

D Number of elbows at risk at 4 years

E 4-year survival (95% CI), percent

F Number of elbows at risk at 7 years

G 7-year survival (95% CI), percent

H Number of elbows at risk at 10 years

I 10-year survival (95% CI), percent

J Number of elbows at risk at 15 years

K 15-year survival (95% CI), percent

L Adjusted RR for revision (95% CI) from the Cox regression analysis (other TEA designs compared to the Souter-Strathclyde prosthesis; adjustment was made for age and sex).

M p-value

Figure 3. Cox-adjusted cumulative survival of the Souter-Strathclyde total elbow replacements used for rheumatoid arthritis in Finland over 2 different time periods. Adjustment was made for age, sex, and type of hospital.