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 1 1 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.