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Infection after total elbow arthroplasty.

B F Morrey, R S Bryan

    The Journal of Bone and Joint Surgery. American Volume
    |March 1, 1983
    PubMed
    Summary

    Deep sepsis occurred in 9% of elbow replacement surgeries. Risk factors include rheumatoid arthritis, prior surgeries, and post-arthroplasty procedures, highlighting the procedure

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    Area of Science:

    • Orthopaedic Surgery
    • Infectious Disease

    Background:

    • Elbow replacement (arthroplasty) is a complex procedure with potential complications.
    • High-risk patient populations, such as those with inflammatory arthritis, may be more susceptible to infection.
    • Previous surgical interventions can influence the risk of subsequent deep-seated infections.

    Purpose of the Study:

    • To determine the incidence of deep sepsis following elbow replacement procedures.
    • To identify risk factors associated with the development of deep sepsis after elbow arthroplasty.
    • To evaluate the outcomes of different surgical interventions for managing deep sepsis.

    Main Methods:

    • Retrospective analysis of 156 elbow replacement procedures in 140 patients.
    • Statistical evaluation of patient demographics, comorbidities, and surgical history in relation to infection rates.
    • Review of treatment strategies employed for deep sepsis, including debridement, reimplantation, and resection arthroplasty.

    Main Results:

    • Deep sepsis occurred in 14 (9%) of the 156 procedures.
    • Significant risk factors for sepsis included rheumatoid arthritis (p<0.02 for prior surgery) and post-arthroplasty surgery (p<0.05).
    • Successful management of deep sepsis was achieved through debridement (1 patient), reimplantation (2 patients), and resection arthroplasty (8 of 10 patients).

    Conclusions:

    • Elbow replacement carries a significant risk of deep sepsis, particularly in patients with rheumatoid arthritis and those undergoing multiple surgeries.
    • Early intervention and appropriate surgical management are crucial for controlling infection and salvaging the affected limb.
    • Orthopaedic surgeons should exercise caution and carefully consider the risks versus benefits when recommending elbow replacement.

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