RESEARCH - 5 to 13-year follow-up of the GSB III total elbow arthroplasty

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J Shoulder Elbow Surg. 2004 Jul-Aug;13(4):434-40.

Five- to thirteen-year follow-up of the GSB III total elbow

arthroplasty.

EW, Coghlan J, Bell S.

Minnesota Orthopedic Specialists, Minneapolis, MN 55454, USA.

ekelly@...

Between 1988 and 1995, the senior author performed total elbow

arthroplasty in 28 elbows (23 patients) with the GSB III prosthesis. At

the most recent follow-up, 7 patients had died (9 elbows) and 1 had the

implant removed because of a deep infection. The remaining 18 elbows (15

patients) were available for clinical and radiographic review at a mean

period of 7.6 years (range, 5.5-11.9 years). All 15 patients were

satisfied with the results of their elbow replacement, with a mean Mayo

elbow performance score of 91 (range, 75-100). The mean

flexion/extension and supination/pronation arcs improved by 33 degrees

and 67 degrees, respectively. Radiographic follow-up demonstrated

progressive loosening in only 1 patient and no progressive loosening in

those with an adequate cement technique. Mild or moderate lysis of the

distal humeral or proximal ulnar components was noted in 10 elbows, and

severe lysis of the distal humerus was seen in 1. Of the patients, 6

(21%) had mild complications: triceps avulsions in 3, superficial wound

infections in 2, and an undisplaced fracture of the distal humeral

medial condyle in 1. In 4 patients (14%) complications developed

requiring reoperation, including exchange of the polyethylene bushing

because of wear, debridement of synovitis, resection arthroplasty for

deep infection, and exploration of an ulnar nerve palsy. In 2 additional

patients (7%), persistent ulnar nerve paresthesias developed

postoperatively. Of the 28 elbow replacements performed with the GSB III

prosthesis, only 1 required revision because of loosening at a mean

follow-up of 7.6 years. The results of this series of GSB III elbow

replacements in patients with rheumatoid arthritis demonstrate

reasonable survivorship of this prosthesis.

PMID: 15220885

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s Hopkins Medicine

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