Previous deep infection was long treated as a strict contraindication to total elbow arthroplasty. This retrospective series asks whether patients whose infection has been eradicated can be salvaged with a semiconstrained (Coonrad-Morrey) prosthesis. Ten consecutive previously infected elbows were reviewed at a mean 4-year follow-up.
When a patient presents with a painful, unstable elbow after a treated deep infection, this paper says reimplantation is a reasonable option rather than a forbidden one. The decision rule: stage the reimplantation, wait a minimum 1-year infection-free interval, and take precautionary cultures before committing to the implant.
Culture status matters more than the calendar. A positive reculture is a poor prognostic sign, and 2 of 4 staged patients here grew organisms despite looking clinically clean.
Weigh the cost carefully. The 20% reinfection rate and 40% complication rate mean this should be reserved for medically competent patients with severe pain and dysfunction, not the frail patient who cannot tolerate repeated debridements. The semiconstrained Coonrad-Morrey design is what makes salvage possible here, restoring stability even with severe bone loss and no ligament support.
Previous deep infection was long treated as a strict contraindication to total elbow arthroplasty. This retrospective series asks whether patients whose infection has been eradicated can be salvaged with a semiconstrained (Coonrad-Morrey) prosthesis. Ten consecutive previously infected elbows were reviewed at a mean 4-year follow-up.
When a patient presents with a painful, unstable elbow after a treated deep infection, this paper says reimplantation is a reasonable option rather than a forbidden one. The decision rule: stage the reimplantation, wait a minimum 1-year infection-free interval, and take precautionary cultures before committing to the implant.
Culture status matters more than the calendar. A positive reculture is a poor prognostic sign, and 2 of 4 staged patients here grew organisms despite looking clinically clean.
Weigh the cost carefully. The 20% reinfection rate and 40% complication rate mean this should be reserved for medically competent patients with severe pain and dysfunction, not the frail patient who cannot tolerate repeated debridements. The semiconstrained Coonrad-Morrey design is what makes salvage possible here, restoring stability even with severe bone loss and no ligament support.