In the Journals

Infection yielded higher revision failure rate after total elbow arthroplasty

Published results showed failure of total elbow arthroplasty due to infection led to a higher likelihood of revision failure and a greater number of subsequent operations compared with failure due to other etiologies.

Researchers retrospectively analyzed the charts of 46 patients who underwent revision total elbow arthroplasty between 2006 and 2016 with a minimum 2-year follow-up. Researchers categorized patients into cohorts by etiology of primary implant failure and compared failure rates, time to second revision and average number of additional revisions among cohorts. Researchers defined the primary outcome of revision failure as the need for a second revision surgical procedure.

Results showed infection (43.5%), aseptic loosening (37%), periprosthetic fracture (13%) and bushing wear (6.5%) were identified as etiologies of primary total elbow arthroplasty failure leading to revision. Researchers grouped all noninfectious etiologies into an additional cohort. Researchers found a significantly greater failure rate and greater number of additional revisions per patient among those who underwent revision for infection compared with patients with aseptic loosening, periprosthetic fracture and the noninfectious group. Patients who underwent revision for infection also experienced a shorter time to failure vs. patients in the noninfectious group, according to results.

“Our results demonstrate that infection is a devastating complication of primary [total elbow arthroplasty] TEA, as patients undergoing revision for this indication experience failure more often and more quickly than those undergoing revision for other indications,” the authors wrote. “Patients who undergo revision for infection are also more likely to require a greater number of additional revision operations.” – by Casey Tingle

Disclosures: DeBernardis reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Published results showed failure of total elbow arthroplasty due to infection led to a higher likelihood of revision failure and a greater number of subsequent operations compared with failure due to other etiologies.

Researchers retrospectively analyzed the charts of 46 patients who underwent revision total elbow arthroplasty between 2006 and 2016 with a minimum 2-year follow-up. Researchers categorized patients into cohorts by etiology of primary implant failure and compared failure rates, time to second revision and average number of additional revisions among cohorts. Researchers defined the primary outcome of revision failure as the need for a second revision surgical procedure.

Results showed infection (43.5%), aseptic loosening (37%), periprosthetic fracture (13%) and bushing wear (6.5%) were identified as etiologies of primary total elbow arthroplasty failure leading to revision. Researchers grouped all noninfectious etiologies into an additional cohort. Researchers found a significantly greater failure rate and greater number of additional revisions per patient among those who underwent revision for infection compared with patients with aseptic loosening, periprosthetic fracture and the noninfectious group. Patients who underwent revision for infection also experienced a shorter time to failure vs. patients in the noninfectious group, according to results.

“Our results demonstrate that infection is a devastating complication of primary [total elbow arthroplasty] TEA, as patients undergoing revision for this indication experience failure more often and more quickly than those undergoing revision for other indications,” the authors wrote. “Patients who undergo revision for infection are also more likely to require a greater number of additional revision operations.” – by Casey Tingle

Disclosures: DeBernardis reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.