• J Orthop Trauma · Sep 2020

    Reoperation Risk After Total Elbow Arthroplasty Versus Open Reduction Internal Fixation for Distal Humerus Fractures in Elderly Patients.

    • Nitin Goyal, Daniel D Bohl, Kevin L Ong, Edmund Lau, Gregory P Nicholson, and Robert W Wysocki.
    • Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL; and.
    • J Orthop Trauma. 2020 Sep 1; 34 (9): 503-509.

    ObjectiveTo compare reoperation risk after total elbow arthroplasty (TEA) and open reduction internal fixation (ORIF) for intra-articular distal humerus fractures in elderly patients.DesignRetrospective comparative.SettingFive percent Medicare Part B claims database.PatientsPatients older than 65 years of age with closed distal humerus fractures undergoing TEA or ORIF from 1996 to 2016.InterventionTEA and ORIF.Main Outcome MeasureReoperation risk based on multivariate Cox proportional hazards modeling.ResultsA total of 142 TEA and 522 ORIF cases were identified. TEA patients had a greater age and Charlson Comorbidity Index , as well as a higher prevalence of rheumatoid arthritis and osteoporosis than ORIF patients (P < 0.05). Although reoperation risk was lower for TEA than that for ORIF within the entire cohort (11.3% vs. 25.1%; hazard ratio = 0.49; P = 0.014), no significant difference was found for TEA and ORIF performed between 2006 and 2016 (12.6% vs. 18.4%; hazard ratio = 0.73; P = 0.380). The death rate was 65.5% in the TEA group at 3.6 years and 55.7% in the ORIF group at 4.9 years.ConclusionsTEA was associated with a decreased reoperation risk compared with ORIF, although this difference did not exist for more recent procedures after popularization of the locking plate technology and half of the reoperations after ORIF were for instrumentation removal. The high death rate within several years of the index procedure may contribute to the low TEA revision rate beyond the short-term when following patients into the medium and long term. Further study comparing TEA and locked plating using prospective, randomized data with long-term follow-up and functional outcomes is warranted.Level Of EvidenceTherapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…