Elbow

Elbow questions and answers

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Table of Contents

Prevention

  • Question 1: What are the optimal prophylactic perioperative antibiotics for patients undergoing total elbow arthroplasty?
  • Question 2: What is the evidence and recommendation for the use of antibiotic-laden bone cement (ALBC): a) In primary total elbow arthroplasty (TEA)? b) In revision TEA?
  • Question 3:Does previous surgery (arthroscopic, fracture fixation, other nonarthroplasty) increase the risk of subsequent elbow PJI after elbow arthroplasty?

Diagnosis

  • Question 1: Is there a role for preoperative joint aspiration in the evaluation of the elbow arthroplasty for PJI?
  • Question 2: What is the role for serum ESR, CRP, or WBC count in the evaluation of an elbow arthroplasty for PJI?
  • Question 3: What is the role of intraoperative histology examination in the evaluation of an elbow arthroplasty for PJI?
  • Question 4: Is there a role for sonication of retrieved implants from an elbow in diagnosis of a possible prosthetic joint infection?
  • Question 5: Do molecular markers have a role in the diagnosis of elbow prosthetic joint infection (PJI)?
  • Question 6: What are the diagnostic criteria for elbow PJI? (Clinical criteria, radiographic criteria, intraoperative findings, pathology, cultures and serum biomarkers)

Treatment

  • Question 1: Is there a role for irrigation and debridement with implant retention (DAIR) when treating acute elbow PJI? Should modular implant parts be exchanged?
  • Question 2: What are the indications for one-stage and two-stage exchange arthroplasty when treating an acute or chronic elbow PJI?
  • Question 3: Is there a role for preoperative joint aspiration prior to second stage revision after treatment of elbow PJI?
  • Question 4: What is the role of permanent resection when treating a chronic elbow PJI?
  • Question 5: What is the role of arthrodesis when treating a chronic elbow PJI?
  • Question 6: Should all foreign material (including cement) be removed during resection arthroplasty of an infected elbow?
  • Question 7: Is there a role for chronic antibiotic suppression in the management of elbow PJI?