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Purpose <p>Periprosthetic joint infection (PJI) is a potentially devastating complication following total elbow arthroplasty. In this retrospective study, we aimed to review our cohort of patients to assess the treatment success rates of elbow PJI using different treatment methods and to report on the additional treatment approach for failed cases.</p> Methods <p>The study included 26 patients who underwent revision surgery for elbow PJI between 2007 and 2023. Patients were enrolled if they possessed a minimum follow-up of two years. Success of different treatment strategies, including debridement, antibiotics, and implant retention (DAIR) with or without modular component exchange, and two-stage revision was evaluated, as well as the fate of patients who experienced initial treatment failure.</p> Results <p>At a mean follow-up of 140.5 ± 74.5&#xa0;months, only 11 patients (42.3%) were successfully treated after a single revision. The overall infection-free survival rates were 65.4% at one year, 50.0% at two years, and 45.8% at five years. DAIR without component exchange had the lowest success (23.1%), while DAIR with modular component exchange and two-stage revision showed the highest (60.0% and 62.5%, respectively). Failed cases (57.7%) required a mean of 2.1 additional procedures to achieve infection control.</p> Conclusion <p>Treatment of elbow PJI remains especially challenging due to an overall high treatment failure. While two-stage exchange appears to be the most effective treatment modality, DAIR with modular component exchange shows promising outcomes in well-fixed prostheses. DAIR without modular components exchange yields poor infection control rates and should be omitted.</p>

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Treatment outcomes of periprosthetic joint infections of the elbow: a retrospective cohort study from a single referral centre

  • 期刊论文

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  • 发表日期：

    2026年1月25日

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  • Matej Mazura,
  • Michal Benes,
  • David Veigl,
  • Rastislav Hromadka,
  • Stanislav Jr. Popelka,
  • Vladislav Bartak

摘要

Purpose

Periprosthetic joint infection (PJI) is a potentially devastating complication following total elbow arthroplasty. In this retrospective study, we aimed to review our cohort of patients to assess the treatment success rates of elbow PJI using different treatment methods and to report on the additional treatment approach for failed cases.

Methods

The study included 26 patients who underwent revision surgery for elbow PJI between 2007 and 2023. Patients were enrolled if they possessed a minimum follow-up of two years. Success of different treatment strategies, including debridement, antibiotics, and implant retention (DAIR) with or without modular component exchange, and two-stage revision was evaluated, as well as the fate of patients who experienced initial treatment failure.

Results

At a mean follow-up of 140.5 ± 74.5 months, only 11 patients (42.3%) were successfully treated after a single revision. The overall infection-free survival rates were 65.4% at one year, 50.0% at two years, and 45.8% at five years. DAIR without component exchange had the lowest success (23.1%), while DAIR with modular component exchange and two-stage revision showed the highest (60.0% and 62.5%, respectively). Failed cases (57.7%) required a mean of 2.1 additional procedures to achieve infection control.

Conclusion

Treatment of elbow PJI remains especially challenging due to an overall high treatment failure. While two-stage exchange appears to be the most effective treatment modality, DAIR with modular component exchange shows promising outcomes in well-fixed prostheses. DAIR without modular components exchange yields poor infection control rates and should be omitted.