Elbow arthroplasty: an Irish perspective

TL;DR

This study examines the current state of elbow arthroplasty in Ireland, finding low surgical volumes and advocating for national policy improvements.

Contribution

The study provides the first comprehensive survey of elbow arthroplasty practices among Irish surgeons and highlights the need for policy change.

Findings

Nineteen surgeons performed 97 elbow arthroplasties over two years, averaging 4 per surgeon.

68% of procedures were total elbow arthroplasties, with 40% related to trauma.

All surgeons expressed a desire to continue performing these procedures.

Abstract

Elbow arthroplasty (EA) aims to restore function and alleviate pain in the elbow joint. Research shows that a higher volume of EAs performed by surgeons and surgical centres correlates with decreased complications, reduced revision rates, and lower healthcare costs.

This study aims to determine the current landscape of elbow arthroplasty in Ireland.

A retrospective cross-sectional study was conducted through surveys distributed to upper limb surgeons in Ireland who performed EAs from October 2022 to October 2024. The survey sought to gather data on the number of procedures completed in the 2-year window. Additionally, it probed surgeons’ intentions to continue performing these surgeries and their views on the necessary number of surgeons for adequate service provision in Ireland.

Nineteen surgeons participated, performing a total of 97 elbow arthroplasties over 2 years, which translates to a median of 4 procedures per surgeon (approximately 2 annually). The cohort included 32% distal humerus hemiarthroplasties (DHHs) and 68% total elbow arthroplasties (TEAs), with 60% classified as elective and 40% as trauma-related. All participants indicated a desire to continue performing these procedures.

The low volume of elbow arthroplasty procedures in Ireland underscores the necessity for a national policy focused on enhancing surgical quality and patient outcomes. The insights gained from this data aim to stimulate discussions among elbow surgeons in Ireland, paving the way for effective policy implementation.

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