Authors' objectives: Since 2004, the committee has undertaken a review of all the products and services registered under generic descriptions in the list of reimbursable products and services (LPPR). This review has concerned standard fabricated elbow joint implants including two main categories of prosthesis: - Total elbow (humero-ulnar) prostheses - Radial head prostheses and custom-made elbow implants. The rarity of the indications for implantation of an elbow prosthesis compared with other prostheses such as hip, knee or shoulder prostheses should be emphasised. In France, operations for arthroplasty of the elbow remain confined to a few clinical conditions such as traumatology and its sequelae, arthritis, rheumatoid arthritis and other even more exceptional or even marginal conditions for implantation (haemophilic arthropathy and tumours). The objectives of this study were to assess the interest of the products, that is to say: - The indications for the different types of prosthesis; - The therapeutic effect/complications ratio; - The place of the product in treatment strategy. Whenever this was possible or necessary, the new modalities of use and prescribing, as well as the technical specifications needed for inclusion of the product in the LPPR, were defined. The working method is based on a systematic review of the literature, the analysis of the dossiers submitted by the manufacturers, and opinion of healthcare professionals meeting in a multidisciplinary working group focussed on the subject.

Authors' recommendations: CNEDiMTS adopted the main points of the working group's proposals, adding some supplementary details about the wording of the indications for the radial head and humero-ulnar standard fabricated prostheses, and on that of the made-to-measure elbow joint implants. Clarification was also added by the Committee concerning the materials which made up certain prostheses defined below (humero-ulnar, humero-radial and distal humeral prostheses). A distinction was drawn between four main categories of standard fabricated joint implants: 1. The radial head prosthesis 2. The humero-ulnar prosthesis 3. The humero-radial prosthesis 4. The distal humeral prosthesis. For the "radial head prosthesis" category, the Committee recommends the creation of three generic descriptions depending on the monoblock or modular nature of the radial head and the materials which comprise it. For the "humero-ulnar prosthesis" category, the Committee recommends the creation of two generic descriptions and one entry for each brand name depending on the mechanism linking of the prostheses (the physical linking of the humeral and ulnar components). For the "humero-radial prosthesis" category, the Committee recommends a general description. Finally, for the last category, "distal humeral prosthesis", the Committee recommends one entry for each brand name. The arguments and the proposed classification are described in the complete report.

Project Status: Completed

Year Published: 2012

URL for published report: http://www.has-sante.fr/portail/upload/docs/application/pdf/2012-09/rapport_suite_cnedimts_pour_publication_2012-09-27_11-40-28_39.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: France

Organisation Name: Haute Autorité de Santé

Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;

Contact Name: has.seap.secretariat@has-sante.fr

Contact Email: has.seap.secretariat@has-sante.fr