About the procedure-

The elbow, a hinge joint, is made up of three bones. These are:

The humerus:The upper arm bone

The radius:The forearm bone found on the side of the thumb

The ulna:The forearm bone found towards the side of the little finger

These three bones meet to form the elbow joint and are covered with articular cartilage. The articular cartilage is a smooth substance that helps protect the bones and allows for ease of movement. The synovial membrane is a thin smooth tissue that covers other surfaces found inside the elbow joint. When the elbow is healthy, this membrane produces a small quantity of fluid to lubricate the cartilage. This removes any friction and allows you to move your arm with ease.

Why is elbow replacement surgery performed?

Damage to the bones or cartilage can lead to chronic, long-term pain, stiffness and swelling of the joint.

Surgeons perform elbow replacement surgery to the increase range of motion and alleviate pain in people with chronic elbow pain. elbow replacement surgery often improves quality of patient’s life when medicines or physiotherapy, exercises to improve mobility and strength, do not relieve their pain adequately.

In the total elbow replacement procedure, a surgeon removes the damaged parts of the joint . These parts are then replaced with artificial components. Artificial elbow joints are made up of metal and plastic hinges with metal stems.

Several factors can cause severe elbow pain. These are:

• Rheumatoid Arthritis
• Severe Fractures
• Post-traumatic Arthritis
• Instability

Types of elbow replacement surgeries-

There are different types of elbow surgeries. These are:

• Total Elbow Replacement
• Open Reduction and Internal Fixation
• Synovectomy
• Arthroscopic Debridement
• Elbow Interposition Arthroplasty

Elbow replacement surgery is a complex procedure because the elbow comprises several parts that allow for movements. The parts balance each other and allow for the seamless movement of the forearm. Some patients may require a partial replacement at the joint, while others may require a complete replacement. For an elbow replacement, there are two main types of prosthetic devices used. These are:

Linked:A hinge connects metal stems implanted into the ends of the ulna and humerus. This type of of prosthetic deviceis most common.

Unlinked:Your own joint tissue connects the metal stems in the ulna and humerus.

Preparing for the surgery

After deciding on an elbow replacement, the patient should plan a complete assessment with their doctor under the direction of the orthopaedic surgeon. The patient should be in good health before they undergo surgery. They must discuss their other diseases such as heart conditions, high blood pressure, and/or diabetes and disclose all chronic medical conditions with their orthopaedic surgeon. Patients must stop medication such as non-steroidal anti-inflammatory medicines like aspirin, naproxen sodium, or ibuprofen at least 2 weeks in advance and must follow pre-procedure guidelines and instructions given by the surgeon.

The health team will prepare the patient for the surgery. Once the patient is under anaesthesia, the orthopaedic surgeon will make an incision close to the back of their elbow. This will allow the surgeon to move the muscles aside to access the bone. The surgeon will then remove scar tissue and spurs found around the joint. After this is done, the humerus is prepared. The ulna will also be prepared. The surgeon will then place the replacement stems into the humerus and ulna bones. This will be held together by bone cement. A hinge pin will be inserted to securely connect the two stems. The surgeon will then close the wound and apply the necessary dressing to protect the cut. The surgeon will place a temporary tube in the joint to drain any excess fluid. This drain will most likely be removed after a few days by an on-duty nurse. The surgery usually takes close to 2 hours. However, this time may depend on your surgeon and your individual case and associated complexities.

After the surgery, the patient must exercise extreme care for their elbow joint and the region around the incision site. Under the guidance of their orthopaedic surgeon, the patient will be advised to stay in hospital for at least 4 days after surgery. Pain is part of the natural healing process however, the surgeon will prescribe several pain medications and antibiotics to ensure that the patient does not develop infections. The patient can also speak to their orthopaedic surgeon about an effective rehabilitation program where they can learn some exercises to avoid stiffness or swelling. After 6 weeks of surgery, the patient will be able to move their hand and apply weight with ease.

Benefits of a total elbow replacement-

Patients who undergo a total elbow replacement surgery will experience:

• Better arm functions
• Lesser pain in damaged elbows
• Improved motion and strength in the hand

Risks and Complications-

Patients who undergo a total elbow replacement surgery may potentially experience certain complications. These can be discussed with your orthopaedic surgeon in detail. Some of these possible complications are:

• Infections
• Implant Complications
• Wound issues
• Nerve injury
• Allergy to the new joint
• Weakness in the elbow

Conclusion

Patients experience better quality of life through total elbow replacement surgery than those who continue to live with an impaired joint. After complete healing, a person can continue to enjoy all the activities of life without any pain or complications which were restricted earlier due to a faulty joint..