Abstract
BackgroundThe aim of this study was to review the long-term results of the instrumented Bone Preserving (iBP) elbow prosthesis.MethodsThirty-one patients (10 M, 21F, 28-77 year) were retrospectively evaluated using the Oxford Elbow Score (OES), Disabilities of Arm, Shoulder and Hand Outcome Measure (DASH), Mayo Elbow Performance (MEPS), physical examination and standard radiographs. Kaplan-Meier survival analysis was used.ResultsThirty-seven primary iBPs have been placed in 31 patients between 2000 and 2007. Six patients (8 prostheses) had died, 10 elbows had been revised and three patients (4 prostheses) were lost to follow-up. Fourteen patients (15 prostheses) were available for follow-up. The main indication for surgery was rheumatoid arthritis. Mean follow-up was 11 years (8–15). Kaplan-Meier survival analysis showed a survival of 81% at 10 years after surgery. Main reason for revision was particle disease and loosening due to instability and malalignment. Eleven of 14 patients were satisfied, although radiographs showed radiolucencies in 11 patients.ConclusionThe iBP elbow prosthesis gives a survival rate of 81% 10 years after surgery with a progressive decline beyond 10 years. However, many patients have radiolucencies. Discrepancy between clinical signs and radiological results warrants structural follow-up, to assure quality of bone stock in case revision surgery is indicated.The study was reviewed and approved by the Medical Ethical Committee of University Medical Center Groningen (METc2016/038).Level of evidenceLevel IV, Case series.
Highlights
The aim of this study was to review the long-term results of the instrumented Bone Preserving elbow prosthesis
As the prevalence of total elbow arthroplasty (TEA) is low compared to knee and hip arthroplasties, reports with long-term follow-up are rather scarce
The humerus and ulna were prepared with preservation of as much bone as possible according to the philosophy of this prosthesis
Summary
The aim of this study was to review the long-term results of the instrumented Bone Preserving (iBP) elbow prosthesis. Joint destruction due to inflammatory arthritis is still the main reason for a total elbow arthroplasty (TEA), nowadays posttraumatic osteoarthritis is a more common indication for a replacement [1, 2]. As the prevalence of TEA is low compared to knee and hip arthroplasties, reports with long-term follow-up are rather scarce. Over the last 40 years there have been many improvements in the design of total elbow prostheses. Release of the collateral ligaments were performed in case of contractures. The radial head was excised in all cases. All humeral components were inserted without cement, except for 6 elbow prostheses in which poor bone quality urged to the use of cement.
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