[Experiences with the GSB (Geschwend-Scheier-Bähler) III total endoprosthesis in the elbow joint]

Studies on the results with elbow prostheses published in the seventies reported on marked problems such as high loosening rates and instabilities of the joints. However, enormous progresses in elbow replacements have been made in the meantime. Therefore, we analyzed the results of the GSB III-elbow-prostheses that were implanted in our department for 9 years. Between January 1, 1987 and April 1995 at our department 34 total elbow replacements were performed in 32 patients. In this study, we reviewed 25 patients with elbow replacements both clinically and radiologically. The clinical outcome was rated according to the score of INGLIS and PELLICI. The mean follow-up time was 3.7 years. Our follow up examination revealed a total complication rate of 22%. Septic prosthesis loosening with explantation of the prostheses occurred in 3 patients resulting in a prosthesis survival-rate of 88%. However, clinical assessment revealed 80% excellent or good results. While the range of motion could only be improved to a small degree, a marked reduction of the preoperative pain could be achieved. Patients were satisfied with the outcome of the operation in 97%. Although the results of total elbow arthroplasties cannot be compared with those of hip or knee arthroplasties, in selected patients with rheumatoid arthritis and osteoathrosis the use of elbow replacements proved to be a successful procedure with satisfactory results. The implantation of elbow prostheses should mainly be considered when debilitating pain, strongly limited range of motion and instability of the joint are the main problems.