A 55-year-old woman with rheumatoid arthritis has disabling pain and loss of motion in the dominant elbow with destruction of both the humeroulnar and radiocapitellar articulations. She needs a stable, mobile elbow for daily activities. The most appropriate definitive surgical option is:
- A Total elbow arthroplasty ✓
- B Radial head excision with capsular release
- C Elbow arthrodesis at 90 degrees of flexion
- D Interposition arthroplasty with Achilles tendon graft
Correct answer: A. Total elbow arthroplasty
Explanation
Total elbow arthroplasty is the established definitive operation for end-stage rheumatoid elbow disease because it addresses pain and restores stability and motion in low-demand patients. Arthrodesis is poorly tolerated in rheumatoid patients who cannot compensate with the opposite limb, radial head excision does not address the destroyed ulnohumeral joint, and interposition arthroplasty is reserved for younger high-demand patients.
Reference: Campbell's Operative Orthopaedics, 14th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.