Ninety-Day Mortality After Total Elbow Arthroplasty

Sanchez-Sotelo, Joaquin; Sperling, John W.; Morrey, Bernard F.
July 2007
Journal of Bone & Joint Surgery, American Volume;Jul2007, Vol. 89-A Issue 7, p1449
Academic Journal
Background: Perioperative mortality, although seldom mentioned and rare after upper-extremity surgery, is one of the potential complications of total elbow arthroplasty. The purpose of this study was to determine the prevalence and risk factors associated with perioperative mortality after elbow arthroplasty. Methods: The records of 1117 consecutive patients who had undergone 1441 total elbow arthroplasties at our institution between 1970 and 2002 were reviewed to identify patients who had died within ninety days after the procedure. A detailed analysis of the medical, surgical, anesthetic, and pathologic records of these patients was performed. Results: The ninety-day mortality rate was 0.62% (nine of 1441 cases). Seven of the patients who died were female and two were male; their mean age at the time of surgery was sixty-six years. An underlying diagnosis of distal humeral fracture (including pathologic fracture) or nonunion was associated with an increased risk of death (p < 0.001). Seven patients died after primary arthroplasty and two, after revision arthroplasty. The average time from surgery to death was forty-five days. The causes of death were congestive heart failure (three patients) and myocardial infarction, acute heart embolus, respiratory failure, pneumonia, renal failure, and bleeding secondary to gastric stress ulcer (one patient each). All patients had substantial comorbidities. Conclusions: The rate of perioperative mortality after total elbow arthroplasty is low. Most patients who die after this procedure are elderly, have substantial comorbidities, and underwent the total elbow arthroplasty for the treatment of a traumatic or pathologic distal humeral fracture or nonunion. Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.


Related Articles

  • THERMAL TISSUE DAMAGE CAUSED BY ULTRASONIC CEMENT REMOVAL FROM THE HUMERUS. Goldberg, Steven H.; Cohen, Mark S.; Young, Michael; Bradnock, Brian // Journal of Bone & Joint Surgery, American Volume;Mar2005, Vol. 87-A Issue 3, p583 

    Background: Ultrasound devices can selectively remove cement during revision arthroplasty. These instruments initially were designed for the hip and knee but also have been applied to the upper extremity. We describe a patient in whom a radial nerve palsy and a pathologic humeral fracture...

  • 4. Elbow and wrist replacement. Edwards, Alison // GP: General Practitioner;5/19/2003, p72 

    Total elbow replacement has improved over years and is a reliable method as of May 19, 2003 for treatment of severe arthritis of joints. It is most commonly used for patients with rheumatoid arthritis but is also being used increasingly as the answer for elderly patients with severe elbow...

  • Total Elbow Replacement as Primary Treatment for Complex Fractures of the Distal Osteopenic Humerus. Müller, Lars Peter; Dietz, Sven-Oliver; Rommens, Pol Maria; Morrey, Bernhard F. // European Journal of Trauma;Apr2003, Vol. 29 Issue 2, p63 

    Background: The use of hip and shoulder arthroplasty in elderly patients for grossly displaced intraarticular fractures is becoming more and more accepted. Total elbow replacement (TER) has not been considered an option for the treatment of extensively comminuted fractures of the distal humerus...

  • And now, total elbow replacement in rheumatoid arthritis. Ewald, Frederick C. // RN;Jul76, Vol. 39 Issue 7, pOR1 

    Reports on the replacement of the elbow joint in patients with rheumatoid arthritis. Indications for the replacement of the elbow joint; Facts on the prosthesis designed for elbow replacement; Procedures in the replacement.

  • What Design and Material Factors Impact the Wear and Corrosion Performance in Total Elbow Arthroplasties? Figgie, Mark; Wright, Timothy; Drinkwater, Denise // Clinical Orthopaedics & Related Research;Dec2014, Vol. 472 Issue 12, p3770 

    Background: The survivorship of total elbow arthroplasties is lower than surgeons and patients would like it to be, especially in patients with posttraumatic arthritis of the elbow. To improve durability, it is important to understand the failure modes of existing implants. Total elbow...

  • Semiconstrained total elbow arthroplasty for rheumatoid arthritis patients: clinical and radiological results of 1-8 years follow-up. Mukka, Sebastian; Berg, Gustaf; Hassany, Hamid; Koye, Alan; Sjödén, Göran; Sayed-Noor, Arkan // Archives of Orthopaedic & Trauma Surgery;May2015, Vol. 135 Issue 5, p595 

    Introduction: We investigated whether the Discovery total elbow arthroplasty (TEA) system had good results and survival in rheumatoid arthritis (RA) patients. Methods: In a prospective cohort study, one elbow surgeon performed TEA on 25 consecutive RA patients (31 elbows) between December 2004...

  • Primary total elbow arthroplasty. Kumar, Suresh; Mahanta, Sunayan // Indian Journal of Orthopaedics;Nov/Dec2013, Vol. 47 Issue 6, p608 

    Background: Primary total elbow arthroplasty (TEA) is a challenging procedure for orthopedic surgeons. It is not performed as frequently as compared to hip or knee arthroplasty. The elbow is a nonweight‑bearing joint; however, static loading can create forces up to three times the body...

  • Are there racial disparities in utilization and outcomes after total elbow arthroplasty? Singh, Jasvinder; Ramachandran, Rekha // Rheumatology International;Sep2015, Vol. 35 Issue 9, p1479 

    The aim of the study was to assess racial disparities in utilization rates and outcomes after primary total elbow arthroplasty (TEA). We used the National Inpatient Sample from 1998 to 2010, a US national database. Patient characteristics, comorbidity and outcomes after TEA were assessed over...

  • A Surgeon With Experience. Ramsay, Maxine // Arthritis Today;Nov/Dec2014, Vol. 28 Issue 6, p6 

    A letter to the editor is presented in response to the article "Elbow Options," in the September-October 2014 issue.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics