Recent Shift in Indication for Total Elbow Arthroplasty

Change from 48 percent due to inflammatory arthritis in '97 to 69 percent due to trauma in '06

TUESDAY, Jan. 24 (HealthDay News) -- The most common indication for total elbow arthroplasty in New York State changed from inflammatory conditions in 1997 to trauma in 2006, with revision and complication rates remaining high, according to a study published in the Jan. 18 issue of The Journal of Bone & Joint Surgery.

David M. Gay, M.D., from Flagler Orthopedics and Sports Medicine in Palm Coast, Fla., and colleagues analyzed a state census of all ambulatory and inpatient surgical procedures between 1997 to 2006, and evaluated 1,155 primary total elbow arthroplasties performed in New York State for complications, readmission, and subsequent surgery data.

The researchers found that 43 percent of total elbow arthroplasties performed in 1997 were associated with trauma and 48 percent with inflammatory conditions, compared with 69 and 19 percent, respectively, in 2006. Twelve percent of all patients were readmitted to the hospital within 90 days, and 5.6 percent were admitted for problems related to the primary surgery. The revision rates were 4.8 percent for traumatic arthroplasties, 8.3 percent for inflammatory arthritis, and 14.7 percent for osteoarthritis, representing an overall revision rate of 6.4 percent. Surgeons with no recorded experience performed 90.5 percent of the total elbow arthroplasties.

"Further investigations into implant design and possibly a higher referral rate to surgeons with greater experience with elbow arthroplasty may result in a reduction in the revision rates and perioperative complications," the authors write.

One or more of the study authors disclosed a financial relationship with an entity in the biomedical arena.

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