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International Orthopaedics

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08.02.2018 | Original Paper

Trends in total elbow arthroplasty: a nationwide analysis in Germany from 2005 to 2014

verfasst von: Alexander Klug, Yves Gramlich, Johannes Buckup, Uwe Schweigkofler, Reinhard Hoffmann, Kay Schmidt-Horlohé

Erschienen in: International Orthopaedics | Ausgabe 4/2018

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Abstract

Purpose

To date, there has been no study investigating the epidemiology and the changes over time, especially regarding indications, in total elbow replacement in Germany.

Methods

Using German procedure classification system (OPS) codes as well as the associated ICD codes, a retrospective analysis from 2005 to 2014 of the data provided by the Federal Statistical Office of Germany was performed. Total elbow arthroplasties (TEAs) were evaluated for admitting diagnoses, sex, and age of patient and distribution of constraint versus unconstraint prostheses. Furthermore, the number and indications of revision elbow arthroplasty (REA) and explantations were identified.

Results

From 2005 to 2014, a total of 3872 patients underwent TEA in Germany. This represents a rise of 84% in this period. Almost 77% of the arthroplasties were performed in females, and over 45% were implanted in patients before the age of 70. During the study, a significant increase in TEA performed on patients for trauma from 12 to 42% and concomitantly, a decrease for the arthritis subgroup from 20 to 2.6% could be revealed. Additionally, almost a doubling of REA in that period could be detected (10.3 to 17.1%). The main revision indication could be found in mechanical complications, such as aseptic loosening (72.1%). Conversely, the number of explantations decreased (12.4 to 5.8%).

Conclusion

During the study period, the number of TEA performed in Germany nearly doubled. Over the years, the most common indication for total elbow arthroplasty changed from inflammatory arthritis to trauma sequel. Further database analysis may help to identify populations at risk and specify reasons for revisions.

Level of evidence: Therapeutic Level IV.

Maradit Kremers H, Larson DR, Crowson CS et al (2015) Prevalence of total hip and knee replacement in the United States. J Bone Joint Surg Am 97(17):1386–1397. https://doi.org/10.2106/JBJS.N.01141 CrossRefPubMedPubMedCentral

Kurtz S, Ong K, Lau E et al (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89(4):780–785. https://doi.org/10.2106/JBJS.F.00222 PubMed

Day JS, Lau E, Ong KL et al (2010) Prevalence and projections of total shoulder and elbow arthroplasty in the United States to 2015. J Shoulder Elb Surg 19(8):1115–1120. https://doi.org/10.1016/j.jse.2010.02.009 CrossRef

Gay DM, Lyman S, Do H et al (2012) Indications and reoperation rates for total elbow arthroplasty: an analysis of trends in New York state. J Bone Joint Surg Am 94(2):110–117. https://doi.org/10.2106/JBJS.J.01128 CrossRefPubMed

Triplet JJ, Kurowicki J, Momoh E et al (2016) Trends in total elbow arthroplasty in the Medicare population: a nationwide study of records from 2005 to 2012. J Shoulder Elb Surg 25(11):1848–1853. https://doi.org/10.1016/j.jse.2016.04.021 CrossRef

Havelin LI, Engesaeter LB, Espehaug B et al (2000) The Norwegian arthroplasty register: 11 years and 73,000 arthroplasties. Acta Orthop Scand 71(4):337–353. https://doi.org/10.1080/000164700317393321 CrossRefPubMed

Fevang B-TS, Lie SA, Havelin LI et al (2009) Results after 562 total elbow replacements: a report from the Norwegian arthroplasty register. J Shoulder Elb Surg 18(3):449–456. https://doi.org/10.1016/j.jse.2009.02.020 CrossRef

Skytta ET, Eskelinen A, Paavolainen P et al (2009) Total elbow arthroplasty in rheumatoid arthritis: a population-based study from the Finnish arthroplasty register. Acta Orthop 80(4):472–477. https://doi.org/10.3109/17453670903110642 CrossRefPubMedPubMedCentral

Rasmussen JV, Olsen BS, Fevang B-TS et al (2012) A review of national shoulder and elbow joint replacement registries. J Shoulder Elb Surg 21(10):1328–1335. https://doi.org/10.1016/j.jse.2012.03.004 CrossRef

10.

Garcia JA, Mykula R, Stanley D (2002) Complex fractures of the distal humerus in the elderly. The role of total elbow replacement as primary treatment. J Bone Joint Surg Br 84(6):812–816CrossRefPubMed

11.

Weiss RJ, Ehlin A, Montgomery SM et al (2008) Decrease of RA-related orthopaedic surgery of the upper limbs between 1998 and 2004: data from 54,579 Swedish RA inpatients. Rheumatology (Oxford) 47(4):491–494. https://doi.org/10.1093/rheumatology/ken009 CrossRef

12.

Korpela M, Laasonen L, Hannonen P et al (2004) Retardation of joint damage in patients with early rheumatoid arthritis by initial aggressive treatment with disease-modifying antirheumatic drugs: five-year experience from the FIN-RACo study. Arthritis Rheum 50(7):2072–2081. https://doi.org/10.1002/art.20351 CrossRefPubMed

13.

Egol KA, Tsai P, Vazques O et al (2011) Comparison of functional outcomes of total elbow arthroplasty vs plate fixation for distal humerus fractures in osteoporotic elbows. Am J Orthop (Belle Mead NJ) 40(2):67–71

14.

Ellwein A, Lill H, Voigt C et al (2015) Arthroplasty compared to internal fixation by locking plate osteosynthesis in comminuted fractures of the distal humerus. Int Orthop 39(4):747–754. https://doi.org/10.1007/s00264-014-2635-0 CrossRefPubMed

15.

McKee MD, Veillette CJH, Hall JA et al (2009) A multicenter, prospective, randomized, controlled trial of open reduction—internal fixation versus total elbow arthroplasty for displaced intra-articular distal humeral fractures in elderly patients. J Shoulder Elb Surg 18(1):3–12. https://doi.org/10.1016/j.jse.2008.06.005 CrossRef

16.

Schmidt-Horlohe KH, Bonk A, Wilde P et al (2013) Promising results after the treatment of simple and complex distal humerus type C fractures by angular-stable double-plate osteosynthesis. Orthop Traumatol Surg Res 99(5):531–541. https://doi.org/10.1016/j.otsr.2013.02.004 CrossRefPubMed

17.

Becker L, Schmidt-Horlohe K, Bonk A et al (2011) Die Ellenbogentotalendoprothese in der Versorgung schwerer Ellenbogenverletzungen des alteren Patienten (Total elbow arthroplasty as a treatment option in complex injuries of the elbow in elderly patients). Z Orthop Unfall 149(5):554–559. https://doi.org/10.1055/s-0030-1271050 CrossRefPubMed

18.

Palvanen M, Kannus P, Niemi S et al (1998) Secular trends in the osteoporotic fractures of the distal humerus in elderly women. Eur J Epidemiol 14(2):159–164CrossRefPubMed

19.

Patil N, Cheung EV, Mow CS (2009) High revision rate after total elbow arthroplasty with a linked semiconstrained device. Orthopedics 32(5):321CrossRefPubMed

20.

The Australian Orthopaedic Association National Joint Replacement Registry (2015) Demographics and Outcome of Elbow & Wrist Arthroplasty: SUPPLEMENTARY SUPPLEMENTARY REPORT 2015(Internet). Available from: https://aoanjrr.dmac.adelaide.edu.au/annual-reports-2014

21.

Association NZO. The New Zealand Joint Registry [Internet] (2015) the new zealand joint registry sixteen year report january 1999 to december 2014. Available from: http://nzoa.org.nz/system/files/Web_DH7657_NZJR2014Report_v4_12Nov15.pdf

22.

Graves SE, Davidson D, Ingerson L et al (2004) The Australian Orthopaedic Association National Joint Replacement Registry. Med J Aust 180(5 Suppl):S31–S34PubMed

23.

Jenkins PJ, Watts AC, Norwood T et al (2013) Total elbow replacement: outcome of 1,146 arthroplasties from the Scottish arthroplasty project. Acta Orthop 84(2):119–123. https://doi.org/10.3109/17453674.2013.784658 CrossRefPubMedPubMedCentral

24.

da Silva E, Doran MF, Crowson CS et al (2003) Declining use of orthopedic surgery in patients with rheumatoid arthritis? Results of a long-term, population-based assessment. Arthritis Rheum 49(2):216–220. https://doi.org/10.1002/art.10998 CrossRefPubMed

25.

Shourt CA, Crowson CS, Gabriel SE et al (2012) Orthopedic surgery among patients with rheumatoid arthritis 1980-2007: a population-based study focused on surgery rates, sex, and mortality. J Rheumatol 39(3):481–485. https://doi.org/10.3899/jrheum.111056 CrossRefPubMedPubMedCentral

26.

Frankle MA, Herscovici D, JR DPTG et al (2003) A comparison of open reduction and internal fixation and primary total elbow arthroplasty in the treatment of intraarticular distal humerus fractures in women older than age 65. J Orthop Trauma 17(7):473–480CrossRefPubMed

27.

Rajaee SS, Lin CA, Moon CN (2016) Primary total elbow arthroplasty for distal humeral fractures in elderly patients: a nationwide analysis. J Shoulder Elb Surg 25(11):1854–1860. https://doi.org/10.1016/j.jse.2016.05.030 CrossRef

28.

Schmidt-Horlohe K, Hoffmann R (2015) Die Gelenkfraktur des alten menschen: to fix or to replace? - Distaler Humerus (articular fractures in the elderly: to fix or to replace? - distal Humerus). Z Orthop Unfall 153(6):597–606. https://doi.org/10.1055/s-0035-1557809 CrossRefPubMed

29.

Cobb TK, Morrey BF (1997) Total elbow arthroplasty as primary treatment for distal humeral fractures in elderly patients. J Bone Joint Surg Am 79(6):826–832CrossRefPubMed

30.

Baksi DP, Pal AK, Baksi D (2011) Prosthetic replacement of elbow for intercondylar fractures (recent or ununited) of humerus in the elderly. Int Orthop 35(8):1171–1177. https://doi.org/10.1007/s00264-010-1122-5 CrossRefPubMed

31.

Obert L, Ferrier M, Jacquot A et al (2013) Distal humerus fractures in patients over 65: complications. Orthop Traumatol Surg Res 99(8):909–913. https://doi.org/10.1016/j.otsr.2013.10.002 CrossRefPubMed

32.

Schmidt AH, Braman JP, Duwelius PJ et al (2014) Geriatric trauma: the role of immediate arthroplasty. Instr Course Lect 63:49–59PubMed

33.

Korner J, Lill H, Müller LP et al (2005) Distal humerus fractures in elderly patients: results after open reduction and internal fixation. Osteoporos Int 16(Suppl 2):S73–S79. https://doi.org/10.1007/s00198-004-1764-5 CrossRefPubMed

34.

Becker L, Schmidt-Horlohe K, Bonk A et al (2011) Total elbow arthroplasty as a treatment option in complex injuries of the elbow in elderly patients (die Ellenbogentotalendoprothese in der Versorgung schwerer Ellenbogenverletzungen des alteren Patienten). Z Orthop Unfall 149(5):554–559. https://doi.org/10.1055/s-0030-1271050 CrossRefPubMed

35.

Obremskey WT, Bhandari M, Dirschl DR et al (2003) Internal fixation versus arthroplasty of comminuted fractures of the distal humerus. J Orthop Trauma 17(6):463–465CrossRefPubMed

36.

Kamineni S, Morrey BF (2005) Distal humeral fractures treated with noncustom total elbow replacement. Surgical technique. J Bone Joint Surg Am 87(Suppl 1(Pt 1)):41–50. https://doi.org/10.2106/JBJS.D.02871 CrossRefPubMed

37.

Park S-E, Kim J-Y, Cho S-W et al (2013) Complications and revision rate compared by type of total elbow arthroplasty. J Shoulder Elb Surg 22(8):1121–1127. https://doi.org/10.1016/j.jse.2013.03.003 CrossRef

38.

Voloshin I, Schippert DW, Kakar S et al (2011) Complications of total elbow replacement: a systematic review. J Shoulder Elb Surg 20(1):158–168. https://doi.org/10.1016/j.jse.2010.08.026 CrossRef

39.

Labek G, Thaler M, Janda W et al (2011) Revision rates after total joint replacement: cumulative results from worldwide joint register datasets. J Bone Joint Surg Br 93(3:293–297. https://doi.org/10.1302/0301-620X.93B3.25467 CrossRef

40.

Krenek L, Farng E, Zingmond D et al (2011) Complication and revision rates following total elbow arthroplasty. J Hand Surg Am 36(1):68–73. https://doi.org/10.1016/j.jhsa.2010.09.036 CrossRefPubMed

41.

Lovy AJ, Keswani A, Dowdell J et al (2016) Outcomes, complications, utilization trends, and risk factors for primary and revision total elbow replacement. J Shoulder Elb Surg 25(6):1020–1026. https://doi.org/10.1016/j.jse.2015.12.012 CrossRef

42.

Ducrot G, Ehlinger M, Adam P et al (2013) Complex fractures of the distal humerus in the elderly: is primary total elbow arthroplasty a valid treatment alternative? A series of 20 cases. Orthop Traumatol Surg Res 99(1):10–20. https://doi.org/10.1016/j.otsr.2012.10.010 CrossRefPubMed

43.

Gambirasio R, Riand N, Stern R et al (2001) Total elbow replacement for complex fractures of the distal humerus. An option for the elderly patient. J Bone Joint Surg Br 83(7):974–978CrossRefPubMed

44.

Plaschke HC, Thillemann TM, Brorson S et al (2014) Implant survival after total elbow arthroplasty: a retrospective study of 324 procedures performed from 1980 to 2008. J Shoulder Elb Surg 23(6):829–836. https://doi.org/10.1016/j.jse.2014.02.001 CrossRef

45.

Celli A, Morrey BF (2009) Total elbow arthroplasty in patients forty years of age or less. J Bone Joint Surg Am 91(6):1414–1418. https://doi.org/10.2106/JBJS.G.00329 CrossRefPubMed

46.

Little CP, Graham AJ, Karatzas G et al (2005) Outcomes of total elbow arthroplasty for rheumatoid arthritis: comparative study of three implants. J Bone Joint Surg Am 87(11):2439–2448. https://doi.org/10.2106/JBJS.D.02927 PubMed

47.

Amirfeyz R, Blewitt N (2009) Mid-term outcome of GSB-III total elbow arthroplasty in patients with rheumatoid arthritis and patients with post-traumatic arthritis. Arch Orthop Trauma Surg 129(11):1505–1510. https://doi.org/10.1007/s00402-009-0876-y CrossRefPubMed

48.

Rydholm U (2009) Arthroplasty of the elbow. Acta Orthop Scand 73(3):247–250. https://doi.org/10.1080/000164702320155194 CrossRef

Titel: Trends in total elbow arthroplasty: a nationwide analysis in Germany from 2005 to 2014
verfasst von: Alexander Klug
Yves Gramlich
Johannes Buckup
Uwe Schweigkofler
Reinhard Hoffmann
Kay Schmidt-Horlohé
Publikationsdatum: 08.02.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: International Orthopaedics / Ausgabe 4/2018
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-018-3818-x

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