The Journal of Bone and Joint Surgery, Vol 65, Issue 3 330-338, Copyright © 1983 by Journal of Bone and Joint Surgery, Inc
Infection after total elbow arthroplasty
BF Morrey and RS Bryan
Deep sepsis occurred after fourteen (9 per cent) of 156 elbow-replacement
procedures in 140 patients. This high frequency of infection was attributed
to several factors. First, the patients were drawn from a population that
was at high risk of infection, because rheumatoid arthritis and
post-traumatic arthritis were the indications for arthroplasty. Second,
many of the patients had had prior surgery, which significantly (p less
than 0.02) increased the risk of sepsis in those with rheumatoid arthritis.
Third, some patients had surgery after the arthroplasty, which also seemed
to predispose to deep infection (p less than 0.05). In one patient the
elbow was salvaged by early debridement, and in two others reimplantation
of a total joint replacement was successful after removal of the first
prosthesis and control of the infection. Resection arthroplasty was
required to arrest the infection in ten patients, eight of whom had a
satisfactory result. The high incidence of this significant complication
attests to the hazardous nature of the elbow-replacement procedure and
should warn orthopaedic surgeons to be cautious when recommending this form
of treatment.
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