Gerow Daniel E, Tan Emily H, Bamberger H Brent
Metro Health-University of Michigan Health, Wyoming, Michigan.
Grandview Medical Center, Dayton, Ohio.
J Shoulder Elb Arthroplast. 2020 Sep 29;4:2471549220961592. doi: 10.1177/2471549220961592. eCollection 2020.
Total elbow arthroplasties (TEA) have become more prevalent as indications expand. However, TEA complications remain a treatment conundrum. One such complication, periprosthetic joint infections (PJIs) have been reported to occur in up to 12% of all TEA procedures. Irrigation and debridement with retention of hardware and antibiotic suppression has a high failure rate. Two stage revisions of TEA, while more morbid, is an effective approach with previous studies showing a 79% eradication rate. These cases are often associated with periprosthetic bone loss, adding to the surgical complexity. In our case report, we present the case of a 59 year old diabetic male with a primary TEA secondary to a distal humerus fracture who developed a deep infection and was successfully treated with explantation, cue ball antibiotic cement arthroplasty, and humeroradial revision. This case report will discuss the cue ball antibiotic spacer technique and humeroradial revision as a salvage procedure in TEA revisions in the setting of extensive ulnar bone loss.
随着适应症的扩大，全肘关节置换术（TEA）越来越普遍。然而，TEA并发症仍然是一个治疗难题。其中一种并发症，假体周围关节感染（PJIs）据报道在所有TEA手术中发生率高达12%。保留内固定物进行冲洗和清创以及抗生素抑制治疗的失败率很高。TEA的两阶段翻修虽然创伤更大，但却是一种有效的方法，先前的研究显示根除率为79%。这些病例通常与假体周围骨丢失有关，增加了手术的复杂性。在我们的病例报告中，我们介绍了一名59岁的糖尿病男性患者，因肱骨远端骨折接受初次TEA手术后发生深部感染，并通过取出假体、使用台球状抗生素骨水泥关节成形术和肱桡关节翻修成功治愈。本病例报告将讨论台球状抗生素间隔物技术和肱桡关节翻修作为在尺骨广泛骨丢失情况下TEA翻修的挽救手术。
