Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2018; 85(1):70-74 | DOI: 10.55095/achot2018/011

Successful Total Elbow Replacement after Septic Arthritis with Staphylococcus aureus - a Case Report and Review of the LiteratureCase report

M. RUPP^*, J. MIKA, C. BIEHL, C. HEISS, V. ALT

Department of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen-Marburg, GmbH, Campus Giessen, Germany

Septic arthritis of the elbow seems to be a contraindication for total elbow arthroplasty (TEA). We here describe a 65-year-old male, American Society of Anesthesiologists (ASA) class 3 - patient, with a severely destructed right elbow due to septic arthritis with Staphylococcus aureus. His treatment consisted of multiple irrigation and debridement procedures including resection of the distal humerus, soft tissue coverage by local rotational flap and the use of a gentamicin-vancomycin loaded PMMA spacer, i.v. and oral antibiotics. After eradication of infection, a constraint cemented TEA could then successfully be performed eight months after the initial surgery and twenty-five weeks after the last debridement procedure. Twenty-one months after the TEA, the patient remained infect free and shows excellent functional results: Disabilities of the Arm, Shoulder and Hand (DASH) score: 38.3, Broberg and Morrey score: 91/100, Mayo elbow score: 95/100.
To the best of our knowledge this is the first case in the literature that demonstrates TEA after septic elbow arthritis with Staphylococcus aureus. Although TEA is known as a typical surgical procedure with a low volume in numbers and higher complication rates, such as elevated infection rates compared to other types of arthroplasty, septic arthritis with Staphylococcus aureus can successfully be performed after eradication of the infection and targeted antibiotic therapy.

Keywords: total elbow arthroplasty, total elbow replacement, septic arthritis, Staphylococcus aureus

Published: February 1, 2018  Show citation