Effect of Obesity on Complication Rate After Elbow Arthroscopy in a Medicare Population

Factors That Increase the Risk of Infection After Elbow Arthroscopy: Analysis of Patient Demographics, Medical Comorbidities, and Steroid Injections in 2,704 Medicare Patients

“…3,5,[11][12][13] Although one prior database study provided a national perspective on complications after elbow arthroscopy, the group was unable to provide any analysis of risk factors for such complications, including infection 2 ; however, another review identified obesity as an independent risk factor for infection after elbow arthroscopy. 10 With the recent growth in popularity and complexity of elbow arthroscopy, it is critical that patients who are at increased risk of postoperative joint space infection be identified. Therefore, the purpose of the present study was to use a national database to determine (1) the incidence of joint infection after elbow arthroscopy, (2) identify independent patient-related risk factors for infection, and (3) determine the influence of concomitant intra-articular corticosteroid injection on infection risk.…”

“…The reported complications in the current literature include peripheral nerve injury, heterotopic ossification, joint stiffness, compartment syndrome, septic arthritis, and obesity. 4,[7][8][9][10] Despite the increase in the use of elbow arthroscopy over the past decade, complication rates remain largely ill-defined and limited to institutional series and case reports. 3,4,[11][12][13] Although septic arthritis after elbow arthroscopy is infrequent, its effects can be devastating to the patient, and this often leads to subsequent procedures, a prolonged course of antibiotics, and an overall decline of joint function.…”

Review of Poehling et al (1989) on elbow arthroscopy: a new technique

“…Identified risk factors for infection after elbow arthroscopy are intra-articular corticosteroid injection during elbow arthroscopy, obesity, age (≥65 years), tobacco usage, alcohol usage, diabetes mellitus, inflammatory arthritis and hypercoagulable disorder 49 61 70 71. Obesity (BMI >30) has also been found to substantially increase the risk for nerve injury or elbow stiffness within 90 days after surgery 70. In general, patients with a history of elbow trauma or previous surgery are at higher risk for complications of elbow arthroscopy, due to distorted anatomy and capsular contraction 57 72…”

Editorial Commentary: Risks Versus Benefits

“…The increased incidence of complications, although relatively small, includes not just those complications related to the procedure, including infection, nerve injury, and stiffness, but also medical complications. There are some limitations in the study by Werner et al, 5 including not accounting for the comorbidities of obesity, which were not assessed as variables, as well as the inherent weakness of retrospectively reviewing a database of patients rather than collecting the data directly and reviewing it. Even with these weaknesses, this study shows that obesity increases the complication rate in elbow arthroscopy.…”