Total Elbow Arthroplasty Survey 2015: Current Service Provision and Future Improvements (England and Wales).

BACKGROUND:The number of total elbow replacement (TER) procedures conducted is relatively low compared to other joint arthroplasties. We have established a survey about current service provision and possible future improvements in the UK. METHODS:A British Elbow and Shoulder Society (BESS) approved online survey was circulated to its surgical members. RESULTS:In total, 153 members of BESS responded. Almost 31% of respondents performed two to five TER in 2014; 28% performed none and 22.7% performed five to ten. Two-thirds of respondents did not perform any revision surgery. The main indication for TER was rheumatoid arthritis (33%), followed by acute trauma (28.5%). In addition, 67% of surgeons have an available 'network' for advice, either locally or regionally. Most primary procedures (93%) were carried out within the local units. However, 34% of complex primary or revision procedures were referred to another centre. Furthermore, 52% of respondents agree that, to be proficient in TER, a minimum number of procedures per annum should be performed: 62% stated that five procedures per annum should be considered as the minimum required. Suggestions for improvement included a hub and spoke model (48%) and a dedicated TER surgeon within the unit (45%). CONCLUSIONS:The survey highlights the interest in exploring options for improving TER provision in the UK.