Abstract
Purpose: In the hands of the conceptors, total elbow prostheses (TEP) have provided favourable results. The purpose of this work was to evaluate our own results in a consecutive series of GSBIII TEP in order to confirm or infirm the mid-term reliability of these prostheses
Material and methods: Over a ten year period, 20 GSBIII TEP were implanted by two operators in 17 patients. The same technique and approach were used in all cases. The patients were reviewed by an independent investigator 12 to 128 months after surgery (mean follow-up 4.3 years). We noted pre- and postoperative pain and motion and recorded the Morrey function score. Patient satisfaction was noted at last follow-up. The Morrey radiological classification (4 stages) was used. The position of the TEP, its stability and its evolution were studied.
Results: Mean age was 51 years (range 19–66) and the underlying rheumatoid polyarthritis had progressed for a mean 14 years. The main indication was pain (mean preoperative visual analogue evaluation = 7/10) All elbows were in stage 3 or more radiographically. At last follow-up, mean pain was 0.3/10 and the function score had improved from 11/25 to 24/25. Gain in motion was 49° in flexion-extension and 42° in pronosupination. Mean satsifaction was scored 8.85/10 and was related to joint motion. At the last follow-up radiological assessment, we found localized metaphyseal bone resorption in three elbows, humeral lucent lines in five, ulnar lucent lines in two (all measuring less than 1 mm, partial and unchanged). There were no neurological, cutaneous or infectious complications. Rate of survival was 100%.
Discussion:At mid-term, we had very favourable results for pain relief and function as well as patient satisfaction. The gain in joint motion was less with a mean extension defect of 20° and was closely related to patient satisfaction.
Conclusion: Our study confirms that this TEP model provides reliable and stable results: no clinical complications were observed during the follow-up nor any loosening. Patient satisfaction was less if the elbow was stiff but with little pain.
The abstracts were prepared by Docteur Jean Barthas. Correspondence should be addressed to him at Secrétariat de la Société S.O.F.C.O.T., 56 rue Boissonade, 75014 Paris.
