Indications and reoperation rates for total elbow arthroplasty

An analysis of trends in New York State

David M. Gay, Leonard Lyman Stephen, Huong Do, Robert N. Hotchkiss, Robert G. Marx, Aaron Daluiski

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Background: Total elbow arthroplasty was originally used to treat patients with arthritis. As familiarity with total elbow arthroplasty evolved, the indications were expanded to include other disorders. There continues to be a low number of total elbow arthroplasties performed each year in comparison with hip, knee, and shoulder arthroplasties, and few large studies have examined the indications and associated complications of total elbow arthroplasty. The purposes of this study were to evaluate the changes with time in the indications for total elbow arthroplasty and to examine the complications of this procedure in a large database. Methods: The Statewide Planning and Research Cooperative System database from the New York State Department of Health, a census of all ambulatory and inpatient surgical procedures in the state of New York, was used to identify individuals who underwent primary total elbow arthroplasty during the time period of 1997 to 2006. These total elbow arthroplasties were evaluated for admitting diagnoses, sex and age of patient, readmission and complication data, and time to subsequent elbow surgery. Results: From 1997 to 2006, there were 1155 total elbow arthroplasties performed in New York State. In 1997, 43% of the total elbow arthroplasties were associated with trauma and 48%, with inflammatory conditions. In 2006, this changed to 69% and 19%, respectively. Within ninety days after the primary total elbow arthroplasty, 12% of the patients were readmitted to the hospital with approximately one-half (5.6%) admitted for problems related to the total elbow arthroplasty. The overall revision rate was 6.4%. The revision rates for the traumatic, inflammatory arthritis, and osteoarthritis groups were 4.8%, 8.3%, and 14.7%, respectively. Of particular interest, 90.5% of the total elbow arthroplasties were performed by surgeons with no recorded experience in the database, which began collecting these data in 1986. Conclusions: This study provides useful information regarding patients undergoing total elbow arthroplasty in New York State. During the study period, the most common indication for total elbow arthroplasty changed from inflammatory arthritis to trauma. Although the number of total elbow arthroplasties being performed each year has increased, there continues to be a high complication and revision rate. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish
Pages (from-to)110-117
Number of pages8
JournalJournal of Bone and Joint Surgery - Series A
Volume94
Issue number2
DOIs
Publication statusPublished - Jan 18 2012

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Elbow
Reoperation
Arthroplasty
Arthritis
Databases
Patient Readmission
Knee Replacement Arthroplasties
Wounds and Injuries
Censuses
Ambulatory Surgical Procedures
Osteoarthritis
Hip
Inpatients

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Indications and reoperation rates for total elbow arthroplasty : An analysis of trends in New York State. / Gay, David M.; Lyman Stephen, Leonard; Do, Huong; Hotchkiss, Robert N.; Marx, Robert G.; Daluiski, Aaron.

In: Journal of Bone and Joint Surgery - Series A, Vol. 94, No. 2, 18.01.2012, p. 110-117.

Research output: Contribution to journalArticle

Gay, David M. ; Lyman Stephen, Leonard ; Do, Huong ; Hotchkiss, Robert N. ; Marx, Robert G. ; Daluiski, Aaron. / Indications and reoperation rates for total elbow arthroplasty : An analysis of trends in New York State. In: Journal of Bone and Joint Surgery - Series A. 2012 ; Vol. 94, No. 2. pp. 110-117.
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N2 - Background: Total elbow arthroplasty was originally used to treat patients with arthritis. As familiarity with total elbow arthroplasty evolved, the indications were expanded to include other disorders. There continues to be a low number of total elbow arthroplasties performed each year in comparison with hip, knee, and shoulder arthroplasties, and few large studies have examined the indications and associated complications of total elbow arthroplasty. The purposes of this study were to evaluate the changes with time in the indications for total elbow arthroplasty and to examine the complications of this procedure in a large database. Methods: The Statewide Planning and Research Cooperative System database from the New York State Department of Health, a census of all ambulatory and inpatient surgical procedures in the state of New York, was used to identify individuals who underwent primary total elbow arthroplasty during the time period of 1997 to 2006. These total elbow arthroplasties were evaluated for admitting diagnoses, sex and age of patient, readmission and complication data, and time to subsequent elbow surgery. Results: From 1997 to 2006, there were 1155 total elbow arthroplasties performed in New York State. In 1997, 43% of the total elbow arthroplasties were associated with trauma and 48%, with inflammatory conditions. In 2006, this changed to 69% and 19%, respectively. Within ninety days after the primary total elbow arthroplasty, 12% of the patients were readmitted to the hospital with approximately one-half (5.6%) admitted for problems related to the total elbow arthroplasty. The overall revision rate was 6.4%. The revision rates for the traumatic, inflammatory arthritis, and osteoarthritis groups were 4.8%, 8.3%, and 14.7%, respectively. Of particular interest, 90.5% of the total elbow arthroplasties were performed by surgeons with no recorded experience in the database, which began collecting these data in 1986. Conclusions: This study provides useful information regarding patients undergoing total elbow arthroplasty in New York State. During the study period, the most common indication for total elbow arthroplasty changed from inflammatory arthritis to trauma. Although the number of total elbow arthroplasties being performed each year has increased, there continues to be a high complication and revision rate. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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