Surgical approaches for total elbow arthroplasties using data from the Dutch Arthroplasty Register

Abstract

Total elbow arthroplasty (TEA) is a relatively infrequently performed procedure. Therefore, nationwide databases help to provide more insight into factors that might influence implant survival, for example, the surgical approach used. Using data from the Dutch Arthroplasty Register, we aimed to reveal whether high-volume centers use different approaches than low-volume centers and whether the approach is implant specific. Using data from 2014 to 2017, we compared the surgical approaches used for high- vs. low-volume centers, as well as for the 2 most frequently used types of TEA, by use of χ2tests. We analyzed 276 procedures. In 2016 and 2017, when posterior approaches were further specified, the triceps-on approach was used most frequently in the high-volume center (27 of 42 procedures, 64%) and the triceps-flap approach was used most often in the low-volume centers (48 of 84 procedures, 57%) (P < .001). For the 2 most frequently used types of TEA, the Coonrad-Morrey and Latitude EV arthroplasties, the surgical approaches did not differ. When the high-volume center was compared with the low-volume centers, implant choice differed, with the Coonrad-Morrey arthroplasty being most often used in the high-volume center and the Latitude EV arthroplasty, in the low-volume centers. The posterior triceps-flap approach was the most frequently used surgical approach in primary TEA in the Netherlands, yet the triceps-on approach was used more often in the high-volume center. The surgical approaches did not differ between the 2 most frequently used types of TEA in the Netherlands.