Prognostic factors associated with failure of total elbow arthroplasty

Z. Hamoodi*, C. K. Gehringer, L. M. Bull, T. Hughes, L. Kearsley-Fleet, J. C. Sergeant, A. C. Watts

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

Aims The aims of this study were to identify and evaluate the current literature examining the prognostic factors which are associated with failure of total elbow arthroplasty (TEA). Methods Electronic literature searches were conducted using MEDLINE, Embase, PubMed, and Cochrane. All studies reporting prognostic estimates for factors associated with the revision of a primary TEA were included. The risk of bias was assessed using the Quality In Prognosis Studies (QUIPS) tool, and the quality of evidence was assessed using the modified Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. Due to low quality of the evidence and the heterogeneous nature of the studies, a narrative synthesis was used. Results A total of 19 studies met the inclusion criteria, investigating 28 possible prognostic factors. Most QUIPS domains (84%) were rated as moderate to high risk of bias. The quality of the evidence was low or very low for all prognostic factors. In low-quality evidence, prognostic factors with consistent associations with failure of TEA in more than one study were: the sequelae of trauma leading to TEA, either independently or combined with acute trauma, and male sex. Several other studies investigating sex reported no association. The evidence for other factors was of very low quality and mostly involved exploratory studies. Conclusion The current evidence investigating the prognostic factors associated with failure of TEA is of low or very low quality, and studies generally have a moderate to high risk of bias. Prognostic factors are subject to uncertainty, should be interpreted with caution, and are of little clinical value. Higher-quality evidence is required to determine robust prognostic factors for failure of TEA.

Original languageEnglish
Pages (from-to)201-213
Number of pages13
JournalBone and Joint Research
Volume13
Issue number5
Early online date1 May 2024
DOIs
Publication statusPublished - 1 May 2024

Keywords

  • Replacement
  • Elbow
  • Prognostic factors
  • Arthroplasty
  • total elbow arthroplasty
  • trauma
  • acute trauma
  • Prognosis
  • MEDLINE
  • arthroplasty surgery
  • revision surgery
  • inflammatory arthritis
  • elbow
  • ulnar components

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