Diagnosis and Management of Periprosthetic Elbow Infection

Periprosthetic elbow infections rarely involve systemic symptoms such as fever or malaise. Unlike tests for periprosthetic hip and knee infections, the diagnostic utility of blood testing and joint aspiration for periprosthetic elbow infection has not been demonstrated to date. Intraoperative histological analysis has good specificity (93.1%) but very low sensitivity (51.3%) for periprosthetic elbow infection. Emerging diagnostic options such as implant sonication, molecular analysis, and advanced synovial fluid cytokine and protein analysis may reduce diagnostic uncertainty in the future. Recommended surgical treatment options for an infection at the site of an elbow arthroplasty include implant retention and debridement, two-stage revision with or without techniques for restoration of bone stock and triceps continuity, and resection arthroplasty.