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European Journal of Orthopaedic Surgery & Traumatology

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29-02-2024 | Rheumatoid Arthritis | Original Article

Open versus arthroscopic treatment of the rheumatoid elbow arthritis: a comparison of complications at two years utilizing a nationally representative database

Authors: Ethan A. Remily, Sandeep S. Bains, Jeremy Dubin, Zhongming Chen, Daniel Hameed, Michael G. Livesey, Tristan B. Weir, Mohit N. Gilotra, John V. Ingari, S. Ashfaq Hasan

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 4/2024

Abstract

Purpose

Symptomatic rheumatoid arthritis (RA) can be addressed surgically with open procedures or elbow arthroscopy. Previous studies comparing outcomes of open to arthroscopic arthrolysis for the management of RA did not utilize a large database study. The aim was to compare demographics and two-year complications, in RA patients undergoing open or arthroscopic elbow arthrolysis.

Methods

A retrospective, cohort study was performed utilizing a private, nationwide, all-payer database. We queried the database to identify patients undergoing open (n = 578) or arthroscopic (n = 379) arthrolysis for elbow RA. The primary goal of the study was to compare complications at two-years. Categorical variables were assessed utilizing the chi-squared test; while, continuous variables were analyzed using the Student’s t-test. Multivariable logistic regression was performed to assess risk factors for infection following open or arthroscopic arthrolysis.

Results

RA patients undergoing open elbow arthrolysis were older (55 vs. 49 years, p < 0.001), predominately female (61.6% vs 60.9%, p = 0.895), and likely to have chronic kidney disease (20.4 vs. 12.9%), and DM (45.2 vs. 32.2%) (both p < 0.005). Open elbow arthrolysis was also associated with higher rates of infection (31.7 vs. 4.7%) and wound complications (26.8 vs. 3.4%) (both p = 0.001). Nerve injury rates were found to be similar (8.3 vs. 9.0%, p = 0.81). On multivariable logistic regression, open elbow procedures were associated with the highest risk for infection (OR: 8.43).

Conclusions

Patients undergoing open arthrolysis for RA were at a higher risk of infection and wound complications compared to arthroscopic arthrolysis utilizing a nationally representative database. While there appears to be a difference in outcomes following these two procedures, higher level evidence is needed to draw more definitive conclusions.

Level of Evidence

Retrospective, Level III

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Title: Open versus arthroscopic treatment of the rheumatoid elbow arthritis: a comparison of complications at two years utilizing a nationally representative database
Authors: Ethan A. Remily
Sandeep S. Bains
Jeremy Dubin
Zhongming Chen
Daniel Hameed
Michael G. Livesey
Tristan B. Weir
Mohit N. Gilotra
John V. Ingari
S. Ashfaq Hasan
Publication date: 29-02-2024
Publisher: Springer Paris
Keywords: Rheumatoid Arthritis
Nerve Injury
Arthroscopy
Arthroscopy
Diabetes
Chronic Kidney Disease
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 4/2024
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-024-03842-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Open versus arthroscopic treatment of the rheumatoid elbow arthritis: a comparison of complications at two years utilizing a nationally representative database

Abstract

Purpose

Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of Evidence

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