Long-term survival of GSB III elbow prostheses and risk factors for revisions

Schöni, Madlaina; Drerup, Susann; Angst, Felix; Kyburz, Diego; Simmen, Beat R.; Goldhahn, Jörg

doi:10.1007/s00402-013-1815-5

Cited by 12 publications

(24 citation statements)

References 24 publications

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“…In contrast, two other cohort studies reported higher reoperation rate, revision rate, and inferior implant survival in the post-traumatic group. 9,10 Rather than an overall risk comparison, we compared each implant failure mode and noted a higher risk of septic loosening in the RA group and a higher risk of bushing wear, axle failure, component disassembly, and component fracture in the post-traumatic group.…”

Section: Discussionmentioning

confidence: 99%

“…Among all, disassembly accounted the majority of the failure modes in the post-traumatic group. 10 Morrey et al 29 reported a consecutive series of 55 TEAs in patients with post-traumatic arthritis. Patients had mostly undergone two operations before the TEA.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 However, outcome reports of TEA for RA and post-traumatic related conditions reveal quite different results. Concerning implant failure, some studies reveal higher overall failure in post-traumatic TEA, 9,10 but another study reported a trend towards a higher overall revision rate in RA-related TEA. 11 For functional outcome, better functional scores have been found in patients with RA patients after TEA, 11-14 but Amirfeyz and Blewitt 15 demonstrated a marked improvement in functional scores in both post-traumatic and RA patients without a significant difference between groups at final follow-up.…”

mentioning

confidence: 99%

“…The literature is unclear about the risk of infection with RA considered to pose a greater risk in some reports, 9,11 but considered similar elsewhere. 10,16,17 Finally, there is limited discussion in the literature about the hazards of intraoperative fracture, postoperative fracture, triceps insufficiency, and neuropathy in these patients.…”

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confidence: 99%

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Outcomes following total elbow arthroplasty for rheumatoid arthritis versus post-traumatic conditions

Wang

Chou

et al. 2019

The Bone & Joint Journal

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AimsThe aim of this meta-analysis was to compare the outcome of total elbow arthroplasty (TEA) undertaken for rheumatoid arthritis (RA) with TEA performed for post-traumatic conditions with regard to implant failure, functional outcome, and perioperative complications.Materials and MethodsWe completed a comprehensive literature search on PubMed, Web of Science, Embase, and the Cochrane Library and conducted a systematic review and meta-analysis. Nine cohort studies investigated the outcome of TEA between RA and post-traumatic conditions. The preferred reporting items for systematic reviews and meta-analysis (Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)) guidelines and Newcastle-Ottawa scale were applied to assess the quality of the included studies. We assessed three major outcome domains: implant failures (including aseptic loosening, septic loosening, bushing wear, axle failure, component disassembly, or component fracture); functional outcomes (including arc of range of movement, Mayo Elbow Performance Score (MEPS), and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire), and perioperative complications (including deep infection, intraoperative fracture, postoperative fracture, and ulnar neuropathy).ResultsThis study included a total of 679 TEAs for RA (n = 482) or post-traumatic conditions (n = 197). After exclusion, all of the TEAs included in this meta-analysis were cemented with linked components. Our analysis demonstrated that the RA group was associated with a higher risk of septic loosening after TEA (odds ratio (OR) 3.96, 95% confidence interval (CI) 1.11 to 14.12), while there was an increased risk of bushing wear, axle failure, component disassembly, or component fracture in the post-traumatic group (OR 4.72, 95% CI 2.37 to 9.35). A higher MEPS (standardized mean difference 0.634, 95% CI 0.379 to 0.890) was found in the RA group. There were no significant differences in arc of range of movement, DASH questionnaire, and risk of aseptic loosening, deep infection, perioperative fracture, or ulnar neuropathy.ConclusionThe aetiology of TEA surgery appears to have an impact on the outcome in terms of specific modes of implant failures. RA patients might have a better functional outcome after TEA surgery.Cite this article: Bone Joint J 2019;101-B:1489–1497

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Outcomes following total elbow arthroplasty for rheumatoid arthritis versus post-traumatic conditions

Wang

Chou

et al. 2019

The Bone & Joint Journal

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“…Current data show a revision-free survivorship of 96.1 % and 92.9 % at 5 and 10 years, respectively, for total shoulder replacement in rheumatoid patients. Within our institution, the survival rates of rheumatoid patients following implantation of a GSB III elbow prosthesis are 85 % at 10 years and 69 % at 20 years [ 10 ]. The risk of revision in rheumatoid patients is generally lower compared to post-traumatic conditions.…”

Section: Long-term Outcomementioning

confidence: 98%

Arthroplasty Procedures for the Rheumatoid Elbow

Glanzmann

Schwyzer

2016

Clinical Management of the Rheumatoid Hand, Wrist, and Elbow

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Why does total elbow arthroplasty fail today? A systematic review of recent literature

Prkić

Welsink

Bekerom

et al. 2017

Arch Orthop Trauma Surg

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Revision rates have been found similar to a systematic review published in 2003. The revision percentage of total elbow arthroplasty for rheumatoid arthritis is significantly higher than for trauma and post-traumatic osteoarthritis. Aseptic loosening was seen less in linked implants. Infections and periprosthetic fractures did not differ between linkage design groups. Aseptic loosening remains the most frequent cause for revision of primary total elbow arthroplasty. Therefore, more research on the occurrence, progression and risk factors of aseptic loosening should be performed and lead to higher implant survival.

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Long-term survival of GSB III elbow prostheses and risk factors for revisions

Abstract: The results indicate a good long-term prognosis for this design. The prognosis has to be adjusted for the underlying disease. Previous operations such as joint reconstruction significantly increase the risk of revision.

Cited by 12 publications

References 24 publications

Outcomes following total elbow arthroplasty for rheumatoid arthritis versus post-traumatic conditions

Outcomes following total elbow arthroplasty for rheumatoid arthritis versus post-traumatic conditions

Arthroplasty Procedures for the Rheumatoid Elbow

Why does total elbow arthroplasty fail today? A systematic review of recent literature

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