Shoulder and elbow arthroplasty: one-stage or two-stage.

Multiple joint replacement in 1 operative session is frequently performed in the lower extremity but less often in the upper extremity. The purpose of the present study is to determine whether a 1-stage arthroplasty of the ipsilateral shoulder and elbow affects the clinical outcome. Replacement of the ipsilateral shoulder and elbow was performed in 34 rheumatoid patients (42 upper extremities). In 11 patients (13 upper limbs), the shoulder and elbow arthroplasty was a 1-stage procedure. The average follow-up of the whole group was 4.5 years (range, 2-12 years). The patients were in a prospective study and evaluated clinically and radiographically. With a 1-stage procedure, the hospitalization time was shorter. The overall Hospital for Special Surgery shoulder score and its items (pain, function, and strength) were similar at follow-up in the 2 groups, and only the motion score showed more improvement in the 1-stage group. The clinical outcome of elbow arthroplasty was similar in both groups, regardless of the sequence of surgery. From this study, it may be concluded that a 1-stage procedure for shoulder and elbow arthroplasty will reduce the hospitalization time and does not adversely affect the clinical outcome.