Use and outcome of 1,220 primary total elbow arthroplasties from the Australian Orthopaedic Association National Joint Arthroplasty Replacement Registry 2008–2018

Authors

  • Jetske Viveen Department of Orthopedic and Trauma Surgery, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia
  • Michel P J van den Bekerom Shoulder and Elbow Unit, Department of Orthopedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
  • Job N Doornberg Department of Orthopedic and Trauma Surgery, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia
  • Alesha Hatton South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia
  • Richard Page Australian Orthopedic Association National Joint Replacement Registry (AOANJRR), Adelaide, SA, Australia; Barwon Centre for Orthopaedic Research and Education (B-CORE), Barwon Health, St John of God Hospital and Deakin University, Geelong, Australia
  • Koen L M Koenraadt Foundation for Orthopedic Research, Care & Education, Amphia Hospital, Breda, The Netherlands
  • Christopher Wilson Department of Orthopedic and Trauma Surgery, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia
  • Gregory I Bain Department of Orthopedic and Trauma Surgery, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia
  • Ruurd L Jaarsma Department of Orthopedic and Trauma Surgery, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia
  • Denise Eygendaal Upper Limb Unit, Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands; Department of Orthopedic Surgery, Amsterdam University Medical Centers, Amsterdam The Netherlands

DOI:

https://doi.org/10.1080/17453674.2019.1657342

Abstract

Background and purpose — The Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) was analyzed to determine trends in use of primary total elbow arthroplasty (TEA), the types of prostheses used, primary diagnoses, reasons for and types of revision, and whether the primary diagnosis or prosthesis design influenced the revision rate.

Patients and methods — During 2008–2018, 1,220 primary TEA procedures were reported of which 140 TEAs were revised. Kaplan–Meier estimates of survivorship were used to describe the time to first revision and hazard ratios (HR) from Cox proportional hazard models, adjusted for age and sex, were used to compare revision rates.

Results — The annual number of TEAs performed remained constant. The 3 most common diagnoses for primary TEA were fracture/dislocation (trauma) (36%), osteoarthritis (OA) (34%), and rheumatoid arthritis (RA) (26%). The cumulative percentage revision for all TEAs undertaken for any reason was 10%, 15%, and 19% at 3, 6, and 9 years. TEAs undertaken for OA had a higher revision rate compared with TEAs for trauma (HR = 1.8, 95% CI 1.1–3.0) and RA (HR = 2.0, CI 1.3–3.1). The Coonrad-Morrey (50%), Latitude (30%), Nexel (10%), and Discovery (9%) were the most used prosthesis designs. There was no difference in revision rates when these 4 designs were compared. The most common reasons for revision were infection (35%) and aseptic loosening (34%).

Interpretation — The indications for primary and revision TEA in Australia are similar to those reported for other registries. Revision for trauma is lower than previously reported.

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Published

2019-08-27

How to Cite

Viveen, J. ., van den Bekerom, M. P. J. ., Doornberg, J. N., Hatton, A., Page, R. ., Koenraadt, K. L. M., Wilson, C., Bain, G. I., Jaarsma, R. L., & Eygendaal, D. (2019). Use and outcome of 1,220 primary total elbow arthroplasties from the Australian Orthopaedic Association National Joint Arthroplasty Replacement Registry 2008–2018. Acta Orthopaedica, 90(6), 511–516. https://doi.org/10.1080/17453674.2019.1657342