Total elbow replacement: outcome of 1,146 arthroplasties from the Scottish Arthroplasty Project

Figures & data

Figure 1. Annual number of TERs over time.

Figure 2. Change in incidence over time for TERs carried out for rheumatoid arthritis.

Figure 3. Change in prevalence versus time for TER performed for non-inflammatory conditions

Table 1. Implant survivorship (Kaplan-Meier) with revision as endpoint, by number of procedures per surgeon per year, diagnosis, and age

	Implant survivorship (%) (endpoint: revision)
	n	10 years	18 years	p-value ^a
Overall		90 (88–93)	85 (81–89)
Average no. of procedures per surgeon per year
0–4	412	90 (86–94)	83 (75–91)	0.02
5–9	296	85 (79–91)	82 (73–90)
≥ 10	319	94 (91–97)	89 (84–95)
Diagnosis
Inflammatory	738	90 (87–93)	84 (78–89)	0.09
Osteoarthritis	95	85 (74–95)	85 (74–95)
Trauma	142	98 (96–100)	98 (96–100)
Unknown	48	87 (76–98)	87 (76–98)
Age
16–54	260	90 (85–94)	81 (73–89)	0.3
55–74	591	90 (86–93)	87 (83–92)
> 74	176	96 (93–99)	96 (93–99)

^a for log-rank test from Kaplan-Meier analysis.

Figure 4. Overall Kaplan-Meier survivorship with revision as endpoint. Bars represent CI.

Table 2. Early complication rates

	No. of early complications (% of total at risk)
	90 days	1 year
Complication	(n = 1,142)	(n = 1,078)
General
DVT/PE	2 (0.2)	4 (0.4)
Death	4 (0.4)	13 (1.2)
Myocardial infarction	3 (0.3)	9 (0.8)
Implant-specific
Infection	22 (1.9)
Dislocation	8 (0.7)
Periprosthetic fracture	35 (3.1)

DVT/PE: Deep venous thrombosis/pulmonary embolism

Table 3. Cumulative complication rate by annual surgeon volume

		10-year complication rate (Kaplan-Meier)
Average no. of procedures per surgeon per year	n	Infection	Dislocation	Periprosthetic fracture
		(n = 86)	(n = 9)	(n = 45)
≤ 4	394	8.3%	0.9%	0.3%
5–9	339	8.7%	0.3%	1.4%
≥ 10	413	7.6%	1.6%	2.1%
Total	1,146	8.2%	0.9%	1.3%
p-value (log-rank)		0.7	0.3	0.9

Table 4. Primary diagnosis by annual surgeon volume

Average no. of procedures per surgeon per year	Primary diagnosis
	Inflammatory	Osteoarthrosis	Trauma	Total
	(n = 828)	(n = 93)	(n = 65)	(n = 986)
≤ 4	217 (81%)	27 (10%)	23 (9%)	267
5–9	272 (81%)	41 (12%)	25 (7%)	338
≥ 10	339 (89%)	25 (7%)	17 (4%)	381
Total	828	93	65	986

p = 0.01