Which primary shoulder and elbow replacement? A review of the results of prostheses available in the UK.
To assist surgeons select a suitable prosthesis, we have undertaken a detailed review of all shoulder and elbow replacements currently marketed in the UK. Twenty shoulder and 8 elbow implants, manufactured by 16 companies, have been identified. Twelve of the shoulder and one of the elbow implants have been introduced or modified in the last 8 years and have no clinical results published in peer-reviewed journals. Only the Biomodular, Bipolar, Copeland, Isoelastic, Neer hemi, Neer II, Roper-Day and Select shoulders accounting for less than 40% of the UK shoulder market, possess published results. The Capitello-condylar, Coonrad-Morrey, GSB III, Kudo, Liverpool, Roper-Tuke and Souter-Strathclyde elbows all have published results. These account for over 95% of all UK elbow replacements. The implications of these findings in an era of evidence-based medicine is discussed. Reviewing the clinical results should be of primary importance in the selection of a suitable prosthesis. Implants with a proven long-term record must represent the 'gold standard'. New or modified implants should only be used if they are part of a properly conducted clinical trial.
Mackay
D C
DC
Department of Orthopaedic Surgery, Freeman Hospital, Newcastle upon Tyne, UK.
Hudson
B
B
Williams
J R
JR
D019643:Arthroplasty, Replacement / Q000009:adverse effects; D004551:Elbow Joint / Q000601:surgery*; D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D011474:Prosthesis Design; D011475:Prosthesis Failure; D020127:Recovery of Function; D012785:Shoulder Joint / Q000601:surgery*; D006113:United Kingdom