Implant survival after total elbow arthroplasty: a retrospective study of 324 procedures performed from 1980 to 2008

Hans Christian Plaschke; Theis M Thillemann; Stig Brorson; Bo S Olsen

doi:10.1016/j.jse.2014.02.001

Implant survival after total elbow arthroplasty: a retrospective study of 324 procedures performed from 1980 to 2008

Hans Christian Plaschke, Theis M Thillemann, Stig Brorson, Bo S Olsen

Department of Clinical Medicine

60 Citations (Scopus)

Abstract

BACKGROUND: Total elbow arthroplasty (TEA) is an established treatment for late-stage arthritis of the elbow. Indications have expanded to osteoarthritis and nonunion in distal humeral fractures. Information on implant survival and risk factors for revision is still sparse. The aim of this study was to evaluate implant survival and risk factors for revision of TEAs inserted in patients in the eastern part of Denmark in the period from 1980 until 2008.

MATERIAL AND METHODS: The Danish National Patient Register provided personal identification numbers for patients who underwent TEA procedures from 1980 until 2008. On the basis of a review of medical reports and linkage to the National Patient Register, we calculated revision rates and evaluated potential risk factors for revision, including, age, sex, period, indication for TEA, and implant design.

RESULTS: We evaluated 324 primary TEA procedures in 234 patients at a mean follow-up of 8.7 years (range, 0-27 years). The overall 5-year survival was 90% (95% confidence interval [CI], 88%-94%), and 10-year survival was 81% (95% CI, 76%-86%). TEAs performed with the unlinked design had a relative risk of revision of 1.9 (95% CI, 1.1-3.2) compared with the linked design. Fracture sequelae was associated with a relative risk of revision of 1.9 (95% CI, 1.05-3.45).

CONCLUSIONS: We found acceptable implant survival rates after 5 and 10 years, with a higher revision rate for the unlinked design and primary TEA due to fracture sequelae. Patient-related outcome measures should be included in future studies for further elaboration of the outcomes after TEA.

LEVEL OF EVIDENCE: Level III, Retrospective cohort design, treatment study.

Original language	English
Journal	Journal of Shoulder and Elbow Surgery
Volume	23
Issue number	6
Pages (from-to)	829–836
Number of pages	8
ISSN	1058-2746
DOIs	https://doi.org/10.1016/j.jse.2014.02.001
Publication status	Published - Jun 2014

Keywords

Adult
Aged
Aged, 80 and over
Arthritis
Arthroplasty, Replacement, Elbow
Cohort Studies
Denmark
Elbow Joint
Female
Humans
Humeral Fractures
Joint Prosthesis
Male
Middle Aged
Prosthesis Failure
Registries
Reoperation
Retrospective Studies
Risk Factors
Treatment Outcome

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10.1016/j.jse.2014.02.001

Cite this

@article{1b8fb1bf3c7142b5ab0e8c2ab7730823,

title = "Implant survival after total elbow arthroplasty: a retrospective study of 324 procedures performed from 1980 to 2008",

abstract = "BACKGROUND: Total elbow arthroplasty (TEA) is an established treatment for late-stage arthritis of the elbow. Indications have expanded to osteoarthritis and nonunion in distal humeral fractures. Information on implant survival and risk factors for revision is still sparse. The aim of this study was to evaluate implant survival and risk factors for revision of TEAs inserted in patients in the eastern part of Denmark in the period from 1980 until 2008.MATERIAL AND METHODS: The Danish National Patient Register provided personal identification numbers for patients who underwent TEA procedures from 1980 until 2008. On the basis of a review of medical reports and linkage to the National Patient Register, we calculated revision rates and evaluated potential risk factors for revision, including, age, sex, period, indication for TEA, and implant design.RESULTS: We evaluated 324 primary TEA procedures in 234 patients at a mean follow-up of 8.7 years (range, 0-27 years). The overall 5-year survival was 90% (95% confidence interval [CI], 88%-94%), and 10-year survival was 81% (95% CI, 76%-86%). TEAs performed with the unlinked design had a relative risk of revision of 1.9 (95% CI, 1.1-3.2) compared with the linked design. Fracture sequelae was associated with a relative risk of revision of 1.9 (95% CI, 1.05-3.45).CONCLUSIONS: We found acceptable implant survival rates after 5 and 10 years, with a higher revision rate for the unlinked design and primary TEA due to fracture sequelae. Patient-related outcome measures should be included in future studies for further elaboration of the outcomes after TEA.LEVEL OF EVIDENCE: Level III, Retrospective cohort design, treatment study.",

keywords = "Adult, Aged, Aged, 80 and over, Arthritis, Arthroplasty, Replacement, Elbow, Cohort Studies, Denmark, Elbow Joint, Female, Humans, Humeral Fractures, Joint Prosthesis, Male, Middle Aged, Prosthesis Failure, Registries, Reoperation, Retrospective Studies, Risk Factors, Treatment Outcome",

author = "Plaschke, {Hans Christian} and Thillemann, {Theis M} and Stig Brorson and Olsen, {Bo S}",

year = "2014",

month = jun,

doi = "10.1016/j.jse.2014.02.001",

language = "English",

volume = "23",

pages = "829–836",

journal = "Journal of Shoulder and Elbow Surgery",

issn = "1058-2746",

publisher = "Mosby Inc.",

number = "6",

}

TY - JOUR

T1 - Implant survival after total elbow arthroplasty

T2 - a retrospective study of 324 procedures performed from 1980 to 2008

AU - Plaschke, Hans Christian

AU - Thillemann, Theis M

AU - Brorson, Stig

AU - Olsen, Bo S

PY - 2014/6

Y1 - 2014/6

N2 - BACKGROUND: Total elbow arthroplasty (TEA) is an established treatment for late-stage arthritis of the elbow. Indications have expanded to osteoarthritis and nonunion in distal humeral fractures. Information on implant survival and risk factors for revision is still sparse. The aim of this study was to evaluate implant survival and risk factors for revision of TEAs inserted in patients in the eastern part of Denmark in the period from 1980 until 2008.MATERIAL AND METHODS: The Danish National Patient Register provided personal identification numbers for patients who underwent TEA procedures from 1980 until 2008. On the basis of a review of medical reports and linkage to the National Patient Register, we calculated revision rates and evaluated potential risk factors for revision, including, age, sex, period, indication for TEA, and implant design.RESULTS: We evaluated 324 primary TEA procedures in 234 patients at a mean follow-up of 8.7 years (range, 0-27 years). The overall 5-year survival was 90% (95% confidence interval [CI], 88%-94%), and 10-year survival was 81% (95% CI, 76%-86%). TEAs performed with the unlinked design had a relative risk of revision of 1.9 (95% CI, 1.1-3.2) compared with the linked design. Fracture sequelae was associated with a relative risk of revision of 1.9 (95% CI, 1.05-3.45).CONCLUSIONS: We found acceptable implant survival rates after 5 and 10 years, with a higher revision rate for the unlinked design and primary TEA due to fracture sequelae. Patient-related outcome measures should be included in future studies for further elaboration of the outcomes after TEA.LEVEL OF EVIDENCE: Level III, Retrospective cohort design, treatment study.

AB - BACKGROUND: Total elbow arthroplasty (TEA) is an established treatment for late-stage arthritis of the elbow. Indications have expanded to osteoarthritis and nonunion in distal humeral fractures. Information on implant survival and risk factors for revision is still sparse. The aim of this study was to evaluate implant survival and risk factors for revision of TEAs inserted in patients in the eastern part of Denmark in the period from 1980 until 2008.MATERIAL AND METHODS: The Danish National Patient Register provided personal identification numbers for patients who underwent TEA procedures from 1980 until 2008. On the basis of a review of medical reports and linkage to the National Patient Register, we calculated revision rates and evaluated potential risk factors for revision, including, age, sex, period, indication for TEA, and implant design.RESULTS: We evaluated 324 primary TEA procedures in 234 patients at a mean follow-up of 8.7 years (range, 0-27 years). The overall 5-year survival was 90% (95% confidence interval [CI], 88%-94%), and 10-year survival was 81% (95% CI, 76%-86%). TEAs performed with the unlinked design had a relative risk of revision of 1.9 (95% CI, 1.1-3.2) compared with the linked design. Fracture sequelae was associated with a relative risk of revision of 1.9 (95% CI, 1.05-3.45).CONCLUSIONS: We found acceptable implant survival rates after 5 and 10 years, with a higher revision rate for the unlinked design and primary TEA due to fracture sequelae. Patient-related outcome measures should be included in future studies for further elaboration of the outcomes after TEA.LEVEL OF EVIDENCE: Level III, Retrospective cohort design, treatment study.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Arthritis

KW - Arthroplasty, Replacement, Elbow

KW - Cohort Studies

KW - Denmark

KW - Elbow Joint

KW - Female

KW - Humans

KW - Humeral Fractures

KW - Joint Prosthesis

KW - Male

KW - Middle Aged

KW - Prosthesis Failure

KW - Registries

KW - Reoperation

KW - Retrospective Studies

KW - Risk Factors

KW - Treatment Outcome

U2 - 10.1016/j.jse.2014.02.001

DO - 10.1016/j.jse.2014.02.001

M3 - Journal article

C2 - 24766794

SN - 1058-2746

VL - 23

SP - 829

EP - 836

JO - Journal of Shoulder and Elbow Surgery

JF - Journal of Shoulder and Elbow Surgery

IS - 6

ER -

Implant survival after total elbow arthroplasty: a retrospective study of 324 procedures performed from 1980 to 2008

Abstract

Keywords

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