CUSTOM MADE ULNAR STEM FOR THE GSB III ELBOW ARTHROPLASTY CLINICAL AND RADIOGRAPHIC FOLLOW UP

Abstract

Introduction: The design of the GSB III elbow arthroplasty has essentially remained unchanged since 1978 until recently. Because of observations of aseptic loosening of the ulnar component, the ulnar stem was changed in an excentric curved shape. The aim of the present study was to assess the clinical and radiographic outcome after more than 2 years of follow up with the new ulnar stem shape.

Patients and methods: Between january 2000 and august 2002, 34 patients had undergone 36 total elbow replacements with the GSB III device with a new curved ulnar shape. Nineteen patients (20 elbows) underwent the operation for the first elbow arthroplasty and 16 patients underwent revision surgery. The mean follow up was 35 months (R: 25–49). The subjective satisfaction and pain intensity were assessed. Clinical exam recorded range of motion and strength. Radiographs were analysed for implant loosening and osteolysis.

Results: There was a significant improvement of the average range of motion in flexion-extension from pre-operative 82degree to postoperative 105degree for all 36 elbows (t-test, p< 0,005). The 20 cases with primary elbow arthroplasty showed a significant improvement in the average range of flexion-extension from 76degree to 106degree (t-test, p< 0,001). The subjective assessment for satisfaction averaged 93 per cent at the time of follow up. For the 16 patients with revision elbow arthroplasty, the average range of flexion-extension improved from 90degree to 103degree (p< 0,01). The mean subjective satisfaction rated at 94 per cent. One case showed a radiolucent line at the ulnar component which remained unchanged at follow up. There was no component loosening.

Discussion: The new excentric curved ulnar component shows no case of component loosening in our series for primary and revision elbow arthroplasty after 2 years. The range of motion and patient satisfaction are promising.