Review Question - QID 4400

TEA for rheumatoid arthritis has been shown to have very positive survival analysis up to 15 years, with studies showing rates of survival rates of over 90%.

Indications for TEA include rheumatoid arthritis, primary osteoarthritis, posttraumatic osteoarthritis (advanced), fracture, and chronic instability. Absolute contraindications include infection and Charcot joint. TEA has the longest average survivorship in patients with rheumatoid arthritis, above those seen in TEA done for: fractures, flail elbow, osteoarthritis, and post-traumatic arthritis.

Alridge et al. provide a 10- to 31-year survival analysis on total elbow arthroplasty with the Coonrad/Coonrad-Morrey prosthesis. They reviewed 40 patients (41 elbows) who had undergone a Coonrad/Coonrad-Morrey elbow arthroplasty. Of the 41 elbows, 21 were functional between 10 and 14 years after operation, ten between 15 and 19 years and ten between 20 and 31 years.

Gill et al. provide a 10- to 15-year survival analysis on total elbow arthroplasty done for rheumatoid arthritis with the Coonrad/Coonrad-Morrey prosthesis. They reviewed 69 patients (78 elbows) who had rheumatoid arthritis and underwent total elbow arthroplasty with the Coonrad/Coonrad-Morrey prosthesis. At the latest clinical follow-up evaluation, according to the Mayo elbow performance score, 43 of the 78 elbows had an excellent result; 26 a good result; 7 a fair result; and 2 a poor result. The rate of survival of the prosthesis was 92.4%, with 86% good or excellent and 14% fair or poor results.

Illustration A shows a lateral x-ray of semiconstrained TEA.