Review Question - QID 3684

Chronic propionibacterium acnes infections of elbow arthroplasty are best treated with two staged revision arthroplasty in healthy patients with adequate bone stock for reimplantation. The algorithm to treat infected total elbow arthroplasty depends on a number of factors including patient characteristics, bacteriology, duration of symptoms, and implant fixation/bone stock.

Yamaguchi et al discuss that poor health status or inadequate bone stock may indicate resection arthroplasty, while acute (<1 month) infections with staph aureus have a greater than 50% chance of success with debridement and retention of components. Most chronic infections or those caused by staph epidermidis or proprionibacterium acnes have high recurrence rates with retention and a two stage revision should be considered with antibiotic spacer and at least 6 weeks of IV antibiotics between staged procedures. Immediate reimplantation in a single stage is controversial and success rates range from 25-75% and are most successful in staph aureus infections.