Elbow Replacement Surgery for Arthritis
The elbow is among the most complex joints in the body made of the upper arm bone called the humerus, and the forearm bones called the radius, and ulna. Cartilage covers the ends of the bones, and the ligaments hold the bones together creating a joint capsule. The hinge joint at the elbow allows up and down movement of the forearm.
Elbow replacement surgery is also called elbow arthroplasty. It is a common surgical procedure used in the management of advanced rheumatoid arthritis, osteoarthritis, psoriatic arthritis, post-traumatic arthritis, and unfixable fractures in the elderly, especially fractures of the distal humerus.
Despite the increasing use of elbow arthroplasty, it is a rare procedure that requires an elbow specialist like Dr. Peter Johnston of Maryland Shoulder and Elbow.
What is Elbow Replacement Surgery?
In elbow replacement surgery the damaged ends of the humerus and the ulna are replaced with artificial prosthetic devices made of metal and plastic to recreate the elbow joint. Elbow replacement surgery is an effective method in treating joint pain an allowing return to the daily activities.
What is the goal of elbow replacement?
The goal is to decrease pain, restore function and mobility and prevent or treat elbow instability.
What are the indications for elbow replacement surgery?
Rheumatoid Arthritis - Chronic inflammation in the joint that damages the cartilage and causes pain and stiffness in patients with inflammatory arthritis.
Osteoarthritis - Wear and tear that destroys the cartilage at the ends of the bones, causing the bones to painfully rub together.
Post Traumatic Arthritis - Arthritis that develops after a serious trauma to the elbow joint or tears to the tendons and ligaments that causes pain and limits mobility.
Severe fractures where one or more elbow bones is shattered and compromised blood supply to the joint. Older people with osteoporosis are at the greatest risk for these fractures. In addition, elderly patients may not heal well after a serious fracture and Dr. Johnston may recommend a joint replacement to restore function and eliminate pain.
Cases of severe joint instability due to trauma may necessitate an elbow joint replacement.
Types of Elbow Replacement Surgery
The type of replacement surgery your doctor chooses for you will depend on your specific condition. While some patients will require a total replacement, some may only need partial replacement. For example, if only a small part of your elbow is damaged like the radial head, your surgeon may replace only that part, called a radial head replacement. However, if you suffer severe elbow damage, you may require a complete replacement. This can come in two ways – linked joint and unlinked joint.
A linked implant is made of two metal stems, one in the humerus and one in the ulna linked together with a cobalt-chrome hinge pin that allows joint articulation. In an unlinked prothesis, the humerus and ulna are not linked, instead stability is provided by the surrounding tissues.
Who is a good candidate?
Because implants generally do not last more than ten years, elbow replacement surgery is a last resort treatment option reserved solely for individuals older than age 60. These patients must be less active with end-stage inflammatory arthritis, osteoarthritis or post traumatic arthritis.
What are the risks?
The risks are the same for all serious surgeries including a risk of infection, blood clots, and nerve damage, as well as implant failure. Serious complications are rare. Patients are evaluated before surgery to assure they are healthy enough for surgery and recovery.
What happens during surgery?
During the procedure, the surgeon will make an incision in the elbow and expose the bones. After proper preparation, he will insert a replacement stem in \ the humerus and the ulna and then join the stems with a hinge pin. Bone cement will be used to keep the stems in the bones. Then the wound will be closed, padded, and allow to heal.
A hospital stay of 2-4 days may be needed. You will wear a soft splint to hold the elbow in position. Your pain will be managed, and a comprehensive rehabilitation plan will be created for each patient.
Patients should anticipate that they will return to the basic actives of daily life within three months, but full recovery can take upto a year
Elbow replacement surgery is a complex procedure that requires specific expertise. Dr. Peter Johnson is a qualified and experienced shoulder and elbow specialist. He uses both open and arthroscopic methods with cutting-edge technology to provide relief and solutions to his patients’ ailments. He specializes in treating all forms of shoulder and elbow conditions, including arthritis, rotator cuff tears, instability, and fracture. Contact Maryland Shoulder and Elbow to schedule a consultation and learn about all your treatment options.
