Management of infection about total elbow prostheses

Area of Science:

• Orthopedic Surgery
• Infectious Disease

Background:

• Total elbow replacement is a surgical procedure to restore function in severe elbow joint damage.
• Deep infection is a significant complication following total elbow arthroplasty.

Observation:

• A study analyzed 164 primary total elbow replacements, identifying 12 cases (7.3%) of deep infection.
• Two additional referred cases of periprosthetic infection were included.
• Preoperative and postoperative factors contributing to infection risk were statistically analyzed.

Findings:

• Identified risk factors for deep infection include prior elbow surgery, previous regional infection, psychiatric illness, class-IV rheumatoid arthritis, postoperative wound drainage, delayed spontaneous drainage, and reoperation.
• Treatment modalities for established infection comprised débridement with implant salvage, resection arthroplasty, and arthrodesis.
• Successful prosthesis retention with functional recovery was achieved in three patients after débridement and antibiotic suppression.

Implications:

• Understanding these risk factors can aid in patient selection and perioperative management to minimize infection rates.
• Effective management strategies exist for established deep periprosthetic infections, including salvage and reconstructive options.
• Further research into preventative measures and optimized treatment protocols for deep infection after total elbow replacement is warranted.