UZH-Logo

Maintenance Infos

Characteristics and outcome of 27 elbow periprosthetic joint infection: Results from a 14-year cohort study of 358 elbow prostheses


Achermann, Y; Vogt, M; Spormann, C; Kolling, C; Remschmidt, C; Wüst, J; Simmen, B; Trampuz, A (2011). Characteristics and outcome of 27 elbow periprosthetic joint infection: Results from a 14-year cohort study of 358 elbow prostheses. Clinical Microbiology and Infection, 17(3):432-438.

Abstract

Abstract Background: Elbow arthroplasty is increasingly performed in patients with rheumatic and posttraumatic arthritis. Data on elbow periprosthetic joint infection (PJI) is limited. We investigated characteristics and outcome of elbow PJI in a 14-year cohort of total elbow arthroplasties in a single center. Methods: Elbow prosthesis, which were implanted between 1994 and 2007 at Schulthess Clinic in Zurich, were retrospectively screened for infection. PJI was defined as periprosthetic purulence, presence of sinus tract or microbial growth. A Kaplan-Meier survival method and Cox proportional hazard analysis was performed. Results: Of 358 elbow prostheses, PJI was identified in 27 (7.5%). The median patient age was 61 (39-82) years, 63% were females. 17 patients (63%) had a rheumatic disorder and 10 (37%) osteoarthritis. Debridement and implant retention was performed in 78%, followed by exchange or removal of the prosthesis (15%) or no surgery (7%).The relapse-free survival (95% confidence interval) was 79% (63% - 95%) after 1 year and 65% (45% - 85%) after 2 years. The outcome after 2 years was significantly better when treated according to the algorithm than in patients which were not (100% versus 33%, p <0.05).In 21 patients treated with debridement and retention, the cure rate was also higher when the algorithm was followed (100% versus 11%, p <0.05). Conclusions: This study suggests that the treatment algorithm developed for hip and knee PJI can be applied to elbow PJI. With proper patient selection and antimicrobial therapy, debridement and retention of the elbow prosthesis is associated with good treatment outcome.

Abstract Background: Elbow arthroplasty is increasingly performed in patients with rheumatic and posttraumatic arthritis. Data on elbow periprosthetic joint infection (PJI) is limited. We investigated characteristics and outcome of elbow PJI in a 14-year cohort of total elbow arthroplasties in a single center. Methods: Elbow prosthesis, which were implanted between 1994 and 2007 at Schulthess Clinic in Zurich, were retrospectively screened for infection. PJI was defined as periprosthetic purulence, presence of sinus tract or microbial growth. A Kaplan-Meier survival method and Cox proportional hazard analysis was performed. Results: Of 358 elbow prostheses, PJI was identified in 27 (7.5%). The median patient age was 61 (39-82) years, 63% were females. 17 patients (63%) had a rheumatic disorder and 10 (37%) osteoarthritis. Debridement and implant retention was performed in 78%, followed by exchange or removal of the prosthesis (15%) or no surgery (7%).The relapse-free survival (95% confidence interval) was 79% (63% - 95%) after 1 year and 65% (45% - 85%) after 2 years. The outcome after 2 years was significantly better when treated according to the algorithm than in patients which were not (100% versus 33%, p <0.05).In 21 patients treated with debridement and retention, the cure rate was also higher when the algorithm was followed (100% versus 11%, p <0.05). Conclusions: This study suggests that the treatment algorithm developed for hip and knee PJI can be applied to elbow PJI. With proper patient selection and antimicrobial therapy, debridement and retention of the elbow prosthesis is associated with good treatment outcome.

Citations

19 citations in Web of Science®
21 citations in Scopus®
Google Scholar™

Altmetrics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:15 Jan 2011 12:51
Last Modified:05 Apr 2016 14:35
Publisher:Wiley-Blackwell
ISSN:1198-743X
Publisher DOI:https://doi.org/10.1111/j.1469-0691.2010.03243.x
PubMed ID:20412190

Download

Full text not available from this repository.View at publisher

TrendTerms

TrendTerms displays relevant terms of the abstract of this publication and related documents on a map. The terms and their relations were extracted from ZORA using word statistics. Their timelines are taken from ZORA as well. The bubble size of a term is proportional to the number of documents where the term occurs. Red, orange, yellow and green colors are used for terms that occur in the current document; red indicates high interlinkedness of a term with other terms, orange, yellow and green decreasing interlinkedness. Blue is used for terms that have a relation with the terms in this document, but occur in other documents.
You can navigate and zoom the map. Mouse-hovering a term displays its timeline, clicking it yields the associated documents.

Author Collaborations