Hans Christian Plaschke1, Theis M Thillemann2, Stig Brorson3, Bo S Olsen3. 1. Shoulder and Elbow Clinic, Department of Orthopedic Surgery, Copenhagen University Hospital, Herlev, Denmark. Electronic address: hcplaschke@dadlnet.dk. 2. Department of Orthopedic Surgery, Horsens Regional Hospital and Aarhus University Hospital, Horsens, Denmark. 3. Shoulder and Elbow Clinic, Department of Orthopedic Surgery, Copenhagen University Hospital, Herlev, Denmark.
Abstract
BACKGROUND: Total elbow arthroplasty (TEA) is an established treatment for late-stage arthritis of the elbow. Indications have expanded to osteoarthritis and nonunion in distal humeral fractures. Information on implant survival and risk factors for revision is still sparse. The aim of this study was to evaluate implant survival and risk factors for revision of TEAs inserted in patients in the eastern part of Denmark in the period from 1980 until 2008. MATERIAL AND METHODS: The Danish National Patient Register provided personal identification numbers for patients who underwent TEA procedures from 1980 until 2008. On the basis of a review of medical reports and linkage to the National Patient Register, we calculated revision rates and evaluated potential risk factors for revision, including, age, sex, period, indication for TEA, and implant design. RESULTS: We evaluated 324 primary TEA procedures in 234 patients at a mean follow-up of 8.7 years (range, 0-27 years). The overall 5-year survival was 90% (95% confidence interval [CI], 88%-94%), and 10-year survival was 81% (95% CI, 76%-86%). TEAs performed with the unlinked design had a relative risk of revision of 1.9 (95% CI, 1.1-3.2) compared with the linked design. Fracture sequelae was associated with a relative risk of revision of 1.9 (95% CI, 1.05-3.45). CONCLUSIONS: We found acceptable implant survival rates after 5 and 10 years, with a higher revision rate for the unlinked design and primary TEA due to fracture sequelae. Patient-related outcome measures should be included in future studies for further elaboration of the outcomes after TEA. LEVEL OF EVIDENCE: Level III, Retrospective cohort design, treatment study.
BACKGROUND:Total elbow arthroplasty (TEA) is an established treatment for late-stage arthritis of the elbow. Indications have expanded to osteoarthritis and nonunion in distal humeral fractures. Information on implant survival and risk factors for revision is still sparse. The aim of this study was to evaluate implant survival and risk factors for revision of TEAs inserted in patients in the eastern part of Denmark in the period from 1980 until 2008. MATERIAL AND METHODS: The Danish National Patient Register provided personal identification numbers for patients who underwent TEA procedures from 1980 until 2008. On the basis of a review of medical reports and linkage to the National Patient Register, we calculated revision rates and evaluated potential risk factors for revision, including, age, sex, period, indication for TEA, and implant design. RESULTS: We evaluated 324 primary TEA procedures in 234 patients at a mean follow-up of 8.7 years (range, 0-27 years). The overall 5-year survival was 90% (95% confidence interval [CI], 88%-94%), and 10-year survival was 81% (95% CI, 76%-86%). TEAs performed with the unlinked design had a relative risk of revision of 1.9 (95% CI, 1.1-3.2) compared with the linked design. Fracture sequelae was associated with a relative risk of revision of 1.9 (95% CI, 1.05-3.45). CONCLUSIONS: We found acceptable implant survival rates after 5 and 10 years, with a higher revision rate for the unlinked design and primary TEA due to fracture sequelae. Patient-related outcome measures should be included in future studies for further elaboration of the outcomes after TEA. LEVEL OF EVIDENCE: Level III, Retrospective cohort design, treatment study.
Authors: Julien Toulemonde; David Ancelin; Vadim Azoulay; Nicolas Bonnevialle; Michel Rongières; Pierre Mansat Journal: Int Orthop Date: 2015-10-05 Impact factor: 3.075
Authors: Alexander Ellwein; Helmut Lill; Christine Voigt; Pauline Wirtz; Gunnar Jensen; Jan Christoph Katthagen Journal: Int Orthop Date: 2014-12-23 Impact factor: 3.075