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. 2019 Sep 6;20(1):415.
doi: 10.1186/s12891-019-2781-z.

Long-term results of the iBP elbow prosthesis: beware of destructive metallosis!

Daniëlle Meijering  1 , Alexander L Boerboom  2 , Fred Breukelman  3 , Denise Eygendaal  4   5 , Sjoerd K Bulstra  2 , Martin Stevens  2
Affiliations

Long-term results of the iBP elbow prosthesis: beware of destructive metallosis!

Daniëlle Meijering et al. BMC Musculoskelet Disord. .

Abstract

Background: The aim of this study was to review the long-term results of the instrumented Bone Preserving (iBP) elbow prosthesis.

Methods: Thirty-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.

Results: Thirty-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.

Conclusion: The 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 evidence: Level IV, Case series.

Keywords: Elbow prosthesis; Long-term follow-up; Unlinked elbow prosthesis; arthroplasty; iBP.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
iBP uncemented (left) and cemented (right) ulnar and humeral components
Fig. 2
Fig. 2
Classification of radiological analysis as described by Wagener et al. In each zone we looked for the presence of radiolucencies
Fig. 3
Fig. 3
Flow diagram of iBP elbow prostheses
Fig. 4
Fig. 4
Kaplan-Meier survival analysis curve with revision for any reasons as an endpoint
Fig. 5
Fig. 5
Radiological signs of PE wear and metallosis. Orange arrows showing radiolucencies, blue arrows showing pseudotumor
Fig. 6
Fig. 6
Revision arthroplasty by humeral osteotomy: severe metallosis
See this image and copyright information in PMC

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