Diagnosis and Management of Periprosthetic Elbow Infection

J Bone Joint Surg Am. 2015 Dec 2;97(23):1962-71. doi: 10.2106/JBJS.O.00170.

Abstract

➤ Periprosthetic elbow infections rarely involve systemic symptoms such as fever or malaise.➤ Unlike tests for periprosthetic hip and knee infections, the diagnostic utility of blood testing and joint aspiration for periprosthetic elbow infection has not been demonstrated to date.➤ Intraoperative histological analysis has good specificity (93.1%) but very low sensitivity (51.3%) for periprosthetic elbow infection.➤ Emerging diagnostic options such as implant sonication, molecular analysis, and advanced synovial fluid cytokine and protein analysis may reduce diagnostic uncertainty in the future.➤ Recommended surgical treatment options for an infection at the site of an elbow arthroplasty include implant retention and debridement, two-stage revision with or without techniques for restoration of bone stock and triceps continuity, and resection arthroplasty.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Anti-Bacterial Agents
  • Arthrodesis
  • Arthroplasty, Replacement, Elbow / instrumentation*
  • Combined Modality Therapy
  • Debridement
  • Decision Support Techniques
  • Elbow Prosthesis / adverse effects*
  • Humans
  • Prosthesis-Related Infections* / diagnosis
  • Prosthesis-Related Infections* / therapy
  • Reoperation

Substances

  • Anti-Bacterial Agents