M John1, K Schenk, S Lieske, H W Neumann. 1. Abteilung für Orthopädie, Universitätsklinik Otto-von-Guericke, Magdeburg, Deutschland. michajohn100@web.de
Abstract
BACKGROUND: Instabilities and dislocations after elbow arthroplasty, in particular in surface or unlinked prostheses, may cause functional impairments occasionally with the need for surgical revision. We provide a review of the literature about the frequency and causes of these complications and present some of our results obtained with the GSB III prosthesis. PATIENTS AND METHODS: We examined the trigger mechanisms and frequency of joint instabilities as well as treatment strategies by studying five internationally used types of prostheses on the basis of published results. We evaluated 160 GSB III prostheses regarding the above complications and determined the causes for uncoupling. RESULTS: Unlinked prostheses dislocate in 0-15% of cases, accounting for about 25% of the total complication rate described. All surface prosthesis models, including GSB III, were affected with variable frequency. For 160 GSB III prostheses, the dislocation rate was 7.4%. Frequent causes were errors of rotation of parts of the prostheses and displacements of the centre of rotation. CONCLUSION: Elbow arthroplasty requires demanding surgery, which is still associated with a comparatively high rate of complications. With correct indication, adequate choice of the type of prosthesis used and sufficient experience gained in surgery techniques, it is possible to considerably lower the rate of disassembling.
BACKGROUND: Instabilities and dislocations after elbow arthroplasty, in particular in surface or unlinked prostheses, may cause functional impairments occasionally with the need for surgical revision. We provide a review of the literature about the frequency and causes of these complications and present some of our results obtained with the GSB III prosthesis. PATIENTS AND METHODS: We examined the trigger mechanisms and frequency of joint instabilities as well as treatment strategies by studying five internationally used types of prostheses on the basis of published results. We evaluated 160 GSB III prostheses regarding the above complications and determined the causes for uncoupling. RESULTS: Unlinked prostheses dislocate in 0-15% of cases, accounting for about 25% of the total complication rate described. All surface prosthesis models, including GSB III, were affected with variable frequency. For 160 GSB III prostheses, the dislocation rate was 7.4%. Frequent causes were errors of rotation of parts of the prostheses and displacements of the centre of rotation. CONCLUSION:Elbow arthroplasty requires demanding surgery, which is still associated with a comparatively high rate of complications. With correct indication, adequate choice of the type of prosthesis used and sufficient experience gained in surgery techniques, it is possible to considerably lower the rate of disassembling.
Authors: Felix Angst; Michael John; Géza Pap; Anne F Mannion; Daniel B Herren; Matthias Flury; André Aeschlimann; Hans-Kaspar Schwyzer; Beat R Simmen Journal: Arthritis Rheum Date: 2005-02-15
Authors: F C Ewald; E D Simmons; J A Sullivan; W H Thomas; R D Scott; R Poss; T S Thornhill; C B Sledge Journal: J Bone Joint Surg Am Date: 1993-04 Impact factor: 5.284