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Review Question - QID 701

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QID 701 (Type "701" in App Search)
A 66 year old woman has chronic elbow pain and loss of function. She has severe morning stiffness and takes several medications for this. Exam reveals a flexion arc from 35-100 degrees with markedly limited rotation. What is the most appropriate definitive treatment?
  • A
  • B

Total elbow arthroplasty

85%

2759/3233

Radial head replacement

1%

38/3233

Radial head excision

2%

73/3233

Corticosteroid injection

2%

59/3233

Elbow arthroscopic debridement and removal of loose bodies

6%

188/3233

  • A
  • B

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Total elbow arthroplasty is the most established definitive surgical treatment for severe rheumatoid arthritis. This patient has pain and loss of function with radiographs that show degenerative changes consistent with rheumatoid arthritis. This would be classified as a Larsen grade C with bony architectural changes on its way to joint destruction (Grade D). This is the original indication for total elbow arthroplasty.

The Kokkalis article is a current concepts review which covers other indications and results.

The Skytta paper is from the Finnish joint registry and looks at the survival rates of different total elbow implant designs. Linked implants have shown improved survival.

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