Elbow arthrodesis common after elbow arthroplasty failure for infection
While elbow arthrodesis is often a salvage procedure, recently published data concerning its likelihood after failed elbow arthroplasty conflicts somewhat with that viewpoint.
“Elbow arthrodesis is not recommended as a salvage procedure for failed total elbow arthroplasty after infection because of a high reoperation rate and difficulty in achieving solid fusion,” Randall J. Otto, MD, and colleagues wrote.
According to the study abstract, Otto and colleagues studied five elbow arthrodeses performed in patients with an average age of 49 years after elbow arthroplasty that failed due to a deep infection. They retrospectively reviewed the cases for fusion angle, complications and time to fusion or resection arthroplasty and used the need for resection arthroplasty or failure of bone union after 1 year to determine if the procedure was a failure.
No patients had a confirmed union at final follow-up and two patients developed a non-symptomatic fibrous union. In all, six reoperations were required, three of which were revision arthrodeses after hardware failure. Two patients ultimately underwent resection arthroplasty. One patient required debridement and hardware removal following wound dehiscence.
Other complications included two cases of transient ulnar neuritis.
Otto R. J Should Elb Surg. 2014;doi: 10.1016/j.jse.2013.11.007
Disclosure: Otto is a paid presenter/speaker for DonJoy Orthopaedics.