This is a retrospective cohort of 69 rheumatoid patients (78 elbows) treated with the semiconstrained Coonrad-Morrey total elbow arthroplasty between 1981 and 1986. It reports 10 to 15-year clinical and radiographic outcomes. The study asks whether the durable early results of this coupled prosthesis are sustained over a decade.
When you see a rheumatoid patient with a painful, unstable, radiographically destroyed elbow, the semiconstrained total elbow arthroplasty is the durable answer, and this paper supplies the ten-year data to justify it.
Understand the design logic: rheumatoid disease destroys the capsuloligamentous restraints, so an uncoupled resurfacing implant cannot rely on soft tissue for stability. The coupled Coonrad-Morrey provides mechanical linkage while its intentional 7 degrees of built-in laxity shares load and protects the fixation interface.
For boards, anchor these numbers: 92.4% ten-year survivorship, 86% good/excellent, and a 3% deep infection rate that exceeds hip and knee arthroplasty because of thin elbow soft-tissue coverage.
The practical decision rule for your patient: counsel strict lifting limits (2.25 kg repetitive, 4.5 kg single-episode) because component fracture follows overload, and expect a worse reoperation profile if the indication is posttraumatic rather than rheumatoid.
This is a retrospective cohort of 69 rheumatoid patients (78 elbows) treated with the semiconstrained Coonrad-Morrey total elbow arthroplasty between 1981 and 1986. It reports 10 to 15-year clinical and radiographic outcomes. The study asks whether the durable early results of this coupled prosthesis are sustained over a decade.
When you see a rheumatoid patient with a painful, unstable, radiographically destroyed elbow, the semiconstrained total elbow arthroplasty is the durable answer, and this paper supplies the ten-year data to justify it.
Understand the design logic: rheumatoid disease destroys the capsuloligamentous restraints, so an uncoupled resurfacing implant cannot rely on soft tissue for stability. The coupled Coonrad-Morrey provides mechanical linkage while its intentional 7 degrees of built-in laxity shares load and protects the fixation interface.
For boards, anchor these numbers: 92.4% ten-year survivorship, 86% good/excellent, and a 3% deep infection rate that exceeds hip and knee arthroplasty because of thin elbow soft-tissue coverage.
The practical decision rule for your patient: counsel strict lifting limits (2.25 kg repetitive, 4.5 kg single-episode) because component fracture follows overload, and expect a worse reoperation profile if the indication is posttraumatic rather than rheumatoid.