Total Elbow Replacement

Total elbow replacement is a surgical procedure where the damaged or arthritic elbow joint is replaced with an artificial joint, also known as a prosthesis. The goal of the surgery is to alleviate pain, restore mobility and function to the elbow, and improve the overall quality of life for patients with severe elbow arthritis or other conditions that affect the elbow joint.

Indications

Total elbow replacement is typically recommended for patients who have:

• Severe rheumatoid arthritis or other forms of inflammatory arthritis that affect the elbow joint
• Osteoarthritis, also known as wear-and-tear arthritis, that has caused significant damage to the elbow joint
• Post-traumatic arthritis, which occurs after a severe injury to the elbow joint
• Avascular necrosis, a condition where the bone tissue dies due to lack of blood supply
• Tumor or cancer that affects the elbow joint

Surgical Procedure

The total elbow replacement surgery typically involves the following steps:

1. The patient is given general anesthesia or regional anesthesia to numb the arm and ensure comfort during the procedure.
2. An incision is made in the back of the elbow to access the joint.
3. The damaged or arthritic joint is removed, and the bones are prepared to accept the prosthetic components.
4. The humeral component (upper arm bone) and radial component (forearm bone) are implanted and secured with cement or screws.
5. The ulnar component (other forearm bone) may also be replaced, depending on the type of prosthesis used.
6. The joint is reduced, and the incision is closed with sutures or staples.

Types of Prostheses

There are several types of elbow prostheses available, including:

• Linked prostheses: These have a hinge that connects the humeral and ulnar components, providing stability and support to the joint.
• Unlinked prostheses: These do not have a hinge and rely on the surrounding soft tissues for stability.
• Semi-constrained prostheses: These provide some stability while still allowing for some movement and flexibility.

Risks and Complications

As with any surgical procedure, total elbow replacement carries certain risks and complications, including:

• Infection
• Bleeding or hematoma
• Nerve damage or numbness
• Fracture or dislocation of the prosthesis
• Loosening or wear of the prosthesis over time

Recovery and Rehabilitation

After total elbow replacement surgery, patients typically require several weeks to several months of recovery and rehabilitation. This may include:

• Pain management with medication and physical therapy
• Range-of-motion exercises to maintain flexibility and mobility
• Strengthening exercises to improve muscle function and support the joint
• Gradual return to daily activities and sports, as recommended by the surgeon or physical therapist.

Outcomes and Expectations

The outcome of total elbow replacement surgery can vary depending on individual factors, such as the underlying condition, overall health, and adherence to post-operative rehabilitation. However, most patients can expect:

• Significant reduction in pain and improvement in function
• Improved range of motion and mobility
• Enhanced quality of life and ability to perform daily activities
• A prosthesis that lasts for 10-20 years or more, depending on the type and wear.