Abstract
Twenty-one elbows in 17 rheumatoid arthritis patients were followed from 3 to 21 years (average 118 months) . The disease in the majority of patients was at an advanced stage. Surgery was performed through a lateral or postero-lateral incision. Fourteen elbows were treated with synovectomy and insertion of a silastic radial head implant; synovectomy with radial head resection was performed in 6 elbows and one elbow was treated with synovectomy only. Pain was diminished in all but one elbow. Range of motion (ROM) improved in 18 elbows, but remained the same as the preoperative level in three elbows. Improvement in ROM was more evident in elbows treated with synovectomy and radial head resection than those without such treatment, and was most apparent in supination of the forearm. Destructive changes in the humeral trochlea and capitellum were less advanced in elbows treated with synovectomy and insertion of radial head implant. Results were graded as satisfactory in 18 elbows (86%) . Synovectomy was effective for relief of pain in the rheumatoid elbow. Considerable improvement in motion can be expected after radial head resection, but insertion of a radial head implant is recommended to minimize destructive changes in the humeral trochlea.
