Arthrodesis for failed total elbow arthroplasty with deep infection

被引:22
作者
Otto, Randall J. [1 ]
Mulieri, Philip J. [2 ]
Cottrell, Benjamin J. [3 ]
Mighell, Mark A. [4 ]
机构
[1] Premier Care Orthoped & Sports Med, St Louis, MO USA
[2] Danbury Orthopaed, Danbury, CT USA
[3] Fdn Orthopaed Res, Tampa, FL USA
[4] Florida Orthopaed Inst, Tampa, FL 33637 USA
关键词
Total elbow arthroplasty; arthrodesis; joint fusion; deep infection; salvage procedure; arthritis; COMPRESSION PLATE ARTHRODESIS; RECONSTRUCTION; ALLOGRAFT; SALVAGE;
D O I
10.1016/j.jse.2013.11.007
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Background: Elbow arthrodesis is typically reserved as a salvage procedure. Current literature suggests that satisfactory outcomes can be expected if fusion occurs. There is a paucity of literature on outcomes of elbow arthrodesis after failed elbow arthroplasty with deep infection. Methods: Five elbow arthrodeses were performed after a failed elbow arthroplasty due to deep infection. Clinical data were retrospectively reviewed for all surviving patients. Fusion angle, complications, and time to fusion or resection arthroplasty were recorded. The procedure was considered a failure if resection arthroplasty was required or there was a failure of bone union after 1 year. Results: The average age at arthrodesis was 49 years (range, 35-69 years). One patient died 3 months after arthrodesis and was excluded from analysis. No patients had confirmed union at final follow-up. Two developed a fibrous union and were not symptomatic. All patients required at least 1 reoperation; 6 reoperations were required in total for the entire group. Three patients required revision arthrodesis after hardware failure. Two patients ultimately underwent a resection arthroplasty. One patient required debridement and hardware removal after wound dehiscence. Other complications included 2 patients with transient ulnar neuritis. Conclusion: 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. (C) 2014 Journal of Shoulder and Elbow Surgery Board of Trustees.
引用
收藏
页码:302 / 307
页数:6
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