Background: Improvements in the design of total
elbow prostheses over the last two decades have led to better and
more consistent results. The type-3 Kudo total elbow prosthesis
was developed in 1980. The long-term results of use of this implant have
not been reported. Because it is an unlinked prosthesis, it is not
known whether preservation of the anterior oblique component of
the ulnar collateral ligament at the time of implantation is important.
Methods: A type-3 Kudo total elbow arthroplasty
with cement was performed in forty-seven patients (fifty elbows)
with rheumatoid arthritis. Revision rates, clinical symptoms, postoperative complications,
and radiographic changes were assessed eleven to sixteen years (mean,
thirteen years) postoperatively.
Results: The overall survival rate of the prosthesis
was 90% at sixteen years. The mean Mayo elbow performance
scores were all poor (mean overall score, 43 points) initially.
The overall score was substantially improved at both the intermediate
follow-up examination (four to six years after the operation) and the
late follow-up examination (eleven to sixteen years after the operation),
to 81 and 77 points, respectively. The overall rate of radiolucency
about the humeral component was 45% at the intermediate
follow-up examination and 100% at the long-term follow-up
examination. The rate of radiolucency about the ulnar component
at the intermediate and late follow-up examinations was 4.3% and
8.9%, respectively. No great differences in results were
found with preservation of the anterior oblique component of the
ulnar collateral ligament.
Conclusions: This long-term follow-up study showed
acceptable results of the type-3 Kudo total elbow arthroplasty in
patients with rheumatoid arthritis. Preservation of the ulnar collateral
ligament does not seem to be necessary when performing this procedure.