The Kudo elbow prosthesis in rheumatoid arthritis

Abstract

The Kudo prosthesis is the most commonly used elbow implant in Sweden. However, there are few reports of the results, besides those reported by Kudo himself. I have implanted 30 Kudo type 4 or 5 elbow prostheses in 28 patients with rheumatoid arthritis. 3 arthroplastics were revised, 2 because of loosening and 1 because of a periprosthetic ulnar fracture. 6 major peroperative or early postoperative complications occurred, but only 1 of these was a failure. 2 patients developed postoperative ulnar neuropathy, one was transient and the other patient died 1 year after surgery. 26 elbows were available for follow-up at an average 5 (2-8) years after implantation. All 26 functioned well although radiographic loosening of the humeral component was found in 1 patient. The average range of flexion increased by 14 degrees while the extension lag was unchanged (35 degrees). Activities of daily living had improved markedly and all but 3 patients were satisfied with their elbow. Radiolucent lines were seen around the proximal part of the ulnar component in 18/26 elbows. Although progressive in 1 patient only, this is a matter of concern, indicating that this component may be the weak part of the Kudo prosthesis.