Nonconstrained total elbow arthroplasty.

Twenty-eight nonconstrained capitellocondylar elbow offhroplasties were performed in 23 patients. The clinical criteria were intractable pain in a joint with radiologic destruction from rheumatoid arthritis. Patients were examined at an average of 35 months postsurgery with the Ewald scoring system. Results were satisfactory in 24 elbows (86%) and unsatisfactory in four (14%). Pain relief and functional improvement were dramatic. The average arc of motion increased from 88 degrees preoperation to 101 degrees postoperation. There was an average 33 degrees residual flexion contracture. There was one failure from loosening, but no radiographic or clinical loosening was detected in the remaining patients. Postoperative dislocation was the most frequent complication, occurring in four cases. One dislocation required revision while three stabilized following four weeks of immobilization. There were two remote infections occurring two and five years postoperation. Although complications are frequent, this is a predictably successful procedure in properly selected patients.