Management of acute septic native elbow arthritis - a systematic review.

Background: Elbow septic arthritis makes up about 6-9% of all septic arthritis cases. Optimum management and outcomes are extrapolated from other large joints and there is very scarce literature specifically for the elbow joint. This systematic review aims to analyse the available evidence on the management and outcomes of native septic arthritis of the elbow.

Methods: A review using PRISMA guidelines was conducted of three databases. Adult patients suffering from native elbow septic arthritis were included. Outcomes of interest included functional outcomes and complications.

Results: About 11 studies with 47 patients were included. The most common causative organism was staphylococcus aureus. About 46 patients were managed with surgery, either arthroscopic or open. About 17 patients, across three studies, had a Mayo Elbow Performance Score reported ranging from 70.0-100.0 and 77% of patients regained range of motion. About 12.9% of patients returned to theatre during their initial infection, 5% of patients developed a repeat infection and there was a 7% mortality rate.

Discussions: This review shows good outcomes for this group of patients, however there is a group who are at risk of significant morbidity and mortality. Further evidence is needed to identify how to optimise treatment in this subset.