Trends in total elbow arthroplasty: a nationwide analysis in Germany from 2005 to 2014
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To date, there has been no study investigating the epidemiology and the changes over time, especially regarding indications, in total elbow replacement in Germany.
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.
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%).
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.
KeywordsTotal elbow arthroplasty Elbow Prosthesis Revision arthroplasty Epidemiology
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 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 CrossRefPubMedGoogle Scholar
- 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):67–71Google Scholar
- 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 CrossRefGoogle Scholar
- 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 CrossRefPubMedGoogle Scholar
- 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 CrossRefPubMedGoogle Scholar
- 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
- 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 CrossRefPubMedGoogle Scholar