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Total elbow arthroplasty in England.

Zaid Hamoodi1,2, Adrian Sayers3, Michael R Whitehouse3,4

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Summary

Total elbow arthroplasties (TEAs) are more common in older, white females. The COVID-19 pandemic reduced TEA incidence and increased waiting times, with no full recovery yet.

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Area of Science:

  • Orthopedic Surgery
  • Arthroplasty
  • Public Health Data Analysis

Background:

  • Total elbow arthroplasty (TEA) is a complex procedure with varying provision across England.
  • Understanding patient demographics, implant types, and service provider characteristics is crucial for optimizing TEA services.

Purpose of the Study:

  • To review the provision of total elbow arthroplasties (TEAs) in England.
  • To analyze incidence, patient and provider characteristics, implant types, and outcomes of TEAs.

Main Methods:

  • Analysis of primary TEAs from the National Joint Registry (NJR) (April 2012-December 2022).
  • Linkage with mortality data and Hospital Episode Statistics-Admitted Patient Care (HES-APC) data.
  • Incidence calculation using Office for National Statistics population estimates.

Main Results:

  • 3,891 primary TEAs were analyzed; incidence declined during COVID-19 but showed slight recovery in 2022.
  • Older patients, white ethnicity, and females were more likely to undergo TEA.
  • Waiting times for elective TEA increased significantly in 2021; patients in lower socioeconomic groups had higher adverse event rates for trauma cases.

Conclusions:

  • TEA provision in England is demographic-specific and was impacted by the COVID-19 pandemic.
  • Elective TEA incidence and waiting times have not fully recovered post-pandemic.
  • Centralizing services could significantly increase TEA volume in specialized centers.