Michael
I am sorry you are having so much pain---and agree that at 52 the risk of early failure of a total replacement warrants moving ahead with that option with considerable caution.
Regarding your "risk of infection", in general---if you were treated with debridement, radial head removal and antibiotics, an aspiration and culture might be a safe 1st step to ensure that another operation would not be contraindicated by persistent infection. That having been said, there is always the risk of recurrent infection.
My sense, from looking at your x-rays , is that an interposition arthroplasty is not going to reliably provide pain relief.
I am wondering whether you have instability/laxity, whether your ulnar nerve function is okay, whether your pain is at the extremes of motion or throughout the arc, and how much you can flex and extend?
Your x-rays show that some joint space is present, so I am wondering whether a contracture or bone spurs may be causing the majority of your pain, in which case a joint debridement and capsular release might potentially be helpful.
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