Parker Phoebe, Furness Nicholas D, Evans Jonathan P, Batten Timothy, White William J, Smith Christopher D
Health Services Policy Research Group, University of Exeter, Exeter, UK.
Shoulder & Elbow Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon & Exeter Hospital, NHS Foundation Trust, Exeter, UK.
Shoulder Elbow. 2021 Oct;13(5):544-551. doi: 10.1177/1758573220905629. Epub 2020 Feb 25.
Total elbow arthroplasty is a low volume procedure. We aimed to evaluate complication rates and cumulative percentages associated with the most frequently used contemporary implants and for the commonest indications.
A systematic literature search of all studies reporting complications following total elbow arthroplasty with 12-month minimum follow-up was undertaken. Quality of studies was assessed with the Methodological-Index-for-Non-Randomised-studies criteria. British NJR data identified the most common UK prostheses and indications. The complication rates for all undesirable events contributing to patient outcome were extracted and cumulative percentages were calculated.
One hundred seventeen studies were screened, 12 studies included, totalling 815 procedures. Mean follow-up was 3.8 years. The overall complication cumulative percentage was 60.7%, significantly higher than that seen in other joint arthroplasty, including a 6.5% deep infection rate. Nerve injury was comparable between implants at around 4.1%. Radiographic loosening had a cumulative rate of 17.2%. Revision for symptomatic aseptic loosening was 6.3%.
This is the largest systematic review of the complications of total elbow arthroplasty. Surgeons should be aware of differing complications related to their implant of choice, each having its own specific complication. Trauma as an indication appears to have an increased complication rates compared to inflammatory arthropathy. There is a lack of literature regarding the independent results of osteoarthritis as a specific indication for total elbow arthroplasty.
全肘关节置换术是一种开展例数较少的手术。我们旨在评估与最常用的当代植入物及最常见适应证相关的并发症发生率和累积百分比。
对所有报告全肘关节置换术后并发症且随访时间至少为12个月的研究进行系统文献检索。采用非随机研究方法学指数标准评估研究质量。英国国家关节注册中心（NJR）的数据确定了英国最常见的假体和适应证。提取所有影响患者预后的不良事件的并发症发生率，并计算累积百分比。
共筛选了117项研究，纳入12项研究，总计815例手术。平均随访时间为3.8年。总体并发症累积百分比为60.7%，显著高于其他关节置换术，其中深部感染率为6.5%。植入物之间的神经损伤发生率相当，约为4.1%。影像学松动的累积发生率为17.2%。因症状性无菌性松动而进行翻修的比例为6.3%。
这是对全肘关节置换术并发症进行的最大规模系统评价。外科医生应了解与其所选植入物相关的不同并发症，每种植入物都有其特定的并发症。与炎性关节病相比，创伤作为适应证时并发症发生率似乎更高。关于骨关节炎作为全肘关节置换术特定适应证的独立研究结果的文献较少。
