THE GUEPAR TOTAL ELBOW ARTHROPLASTY

The Guepar total elbow replacement is a low friction, minimally constr ained gliding prosthesis. The humeral and ulnar components are of meta l with intramedullary stems, which are cemented. There is a sigmoid sh aped, high density polyethylene interposition bearing. The authors hav e used the prosthesis in 33 patients with rheumatoid arthritis, 4 with post-traumatic problems, one with chondrocalcinosis and another with degenerative changes of uncertain aetiology. In the patients with rheu matoid arthritis, one sustained a posterior dislocation and two suffer ed deep infection. In the remaining 30, the overall results were good at an average review of 32 months. The mean range of movement had incr eased by 31-degrees and pain was absent in 28 elbows. In the managemen t of rheumatoid arthritis total elbow arthroplasty must be part of an overall plan of treatment. Severe involvement of the wrist and shoulde r must be dealt with before elbow replacement is considered.