Objective: Total elbow arthroplasty (TEA) is a commonly performed surgical technique for the management of elbow disorders. The Coonrad–Morrey (CM) prosthesis is the most commonly used prosthesis in TEA. The study from Chinese cohorts remains limited, particularly regarding differences between patients with and without RA. Therefore, the purpose of this study was to evaluate the medium- to long-term clinical outcomes using the CM prosthesis in a Chinese cohort, and to compare clinical outcomes between patients with and without RA.
Methods: A retrospective cohort study was conducted involving 74 patients (75 elbows) who underwent TEA using CM prostheses between March 2015 and February 2019. All patients were followed up for a minimum of 5 years (mean follow-up: 83.4 months) and were assessed for elbow range of motion (ROM), Mayo Elbow Performance Score (MEPS), Quick-Disabilities of the Arm, Shoulder and Hand (Quick-DASH) score, pain, complications, and revision surgeries. Kaplan–Meier survivorship analysis was conducted. The differences between patients with and without rheumatoid arthritis (RA) were compared in the subgroup analysis.
Results: At the final follow-up, the average flexion-extension ROM was 105.3° ± 33.6°. The mean MEPS was 85.5 ± 14.3, with a good-to-excellent rate of 81.3%. The mean Quick-DASH score was 30.8 ± 18.1. A total of 26 complications (26/75, 34.7%) were observed in 22 elbows (22/75, 29.3%). Nine elbows (9/75, 12.0%) underwent reoperation. The revision-free rates were 98.7% at 1 year, 94.7% at 2 years, and 90.7% at 5 years. There were no significant differences in elbow function or revision-free rate between patients with and without RA.
Conclusion: TEA using CM prosthesis in Chinese patients can achieve favorable functional outcomes regardless of RA status, with a high 5-year prosthesis survival rate. However, a larger sample size and a longer follow-up period are still required.
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