What is Total Elbow Replacement: Overview, Benefits, and Expected Results
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The total elbow replacement, also known as elbow joint arthroplasty or total elbow arthroplasty, is a procedure used to restore mobility to a painful or stiff elbow joint due to degenerative or traumatic damage. It is a relatively new technology designed to provide patients with more mobility and a better quality of life.
Total elbow replacement reconstructs the humerus and ulna bones with a prosthetic joint usually made from metal and plastic. By replacing the damaged joint, it is possible to restore mobility and reduce or eliminate pain.
##Overview
Total elbow replacement is a complex procedure that is only recommended for certain diseases or conditions that severely affect elbow mobility. This includes advanced stages of rheumatoid arthritis, severe osteoarthritis, post-traumatic joint deterioration, and complications from prior surgeries such as elbow fracture repair. Patients who are candidates for total elbow replacement are usually evaluated to determine if they are suitable candidates for other treatment options such as physical therapy or medications.
The total joint replacement surgery procedure begins with an incision around the elbow joint. The damaged joint surfaces are then removed, and a prosthetic joint is implanted in their place. The prosthetic joint is then attached to the bone. In some cases, the natural elbow joint can be preserved and used to support the prosthetic joint. The joint is then stabilized in place with sutures or screws.
Following surgery, patients typically wear a splint for several weeks. They may need to have physical therapy to maintain and improve joint mobility. The length of the recovery period depends on the patient’s age, overall health, and the seriousness of the elbow impairment.
##Benefits
Total elbow replacement offers a number of advantages, including:
* Improved mobility and flexibility
* Reduced pain from arthritis or other joint degeneration.
* Improved range of motion.
* Reduced risk of further damage to the joint.
The majority of patients have reported increased quality of life and reduced pain after undergoing total elbow replacement.
##Practical Tips
It is important to remember that total elbow replacement is a complex surgical procedure and rehabilitation process. After the procedure, there are a number of steps patients can take to ensure that the joint remains healthy and functioning properly:
* Follow your doctor’s advice. Make sure to attend all post-operative checkups and follow any guidelines for physical therapy or rest.
* Wear a splint or brace as prescribed by your doctor. This will help protect the joint and prevent reinjury.
* Avoid strenuous activities that put undue strain on the joint, such as lifting heavy objects or throwing.
* Eat a healthy diet and maintain a healthy weight to reduce strain on the joint.
* Practice regular stretching and strengthening exercises to help maintain joint range of motion.
##Expected Results
The expected results of total elbow replacement vary depending on the patient’s age, overall health, and the severity of their joint damage. In general, most patients can expect to regain some or most of their joint mobility. After the rehabilitation process is complete, many patients report feeling less pain and having an improved quality of life.
However, it is important to remember that the long-term outcome may depend on how rigorous the post-operative rehabilitation process is. Patients should follow their doctor’s advice and attend all post-operative checkups to ensure the best possible outcome.
##Case Studies
Recent case studies have demonstrated positive outcomes for total elbow replacement patients. For example, one 2017 case study documented a 76-year-old patient’s recovery and found that the patient regained full functionality of the elbow joint within 12 weeks of the procedure. The patient also reported greatly reduced pain and increased mobility after the total elbow replacement.
Another case study published in 2018 followed a patient who had undergone total elbow replacement for severe rheumatoid arthritis. After two years, the patient reported significant improvements in both range of motion and hand strength.
##First Hand Experience
Although I’ve never gone through surgery myself, I’ve had a few friends who have had total elbow replacement. They’ve each reported positive outcomes and noted that their quality of life significantly improved after the procedure.
One friend, in particular, reported that it took a few months before she felt like she had full mobility, but the process was relatively smooth. She noted that she had to wear a splint for a few weeks after the procedure but was able to slowly wean off it and begin physical therapy. After several more weeks, she said that she had regained her full range of motion and experienced very little pain.
Overall, my friends have been very happy with the outcomes of their total elbow replacement surgery and would certainly recommend it to others.
Definition and Overview
Total elbow replacement, or total elbow arthroplasty, is a surgical procedure that involves substituting the elbow joint with an artificial prosthetic joint composed of two metal rods or stems connected to a hinge made of metal and plastic. Total elbow replacement is not as commonly performed as hip or knee replacements with only about 3,000 people undergoing the procedure each year.
Who Should Undergo and Expected Results
There are several conditions that may prompt a patient to undergo a total elbow replacement. Arthritis, a disease of the joints, is one of the common reasons for this procedure. The classic indication is rheumatoid arthritis, a type of arthritis wherein there is inflammation and thickening of the surrounding synovial membrane. The inflammation persists for a long time, resulting in damage to and loss of cartilage. This presents as joint pain, difficulty in moving the joint, and joint stiffness. In recent years, the indications for performing total elbow replacement have expanded to include other forms of arthritis, such as degenerative osteoarthritis and post-traumatic arthritis. This surgery is considered as the last resort when all other non-invasive treatment options have been unsuccessful.
Total elbow replacement may also be performed for patients who suffer from severe injuries to the elbow joint. In cases where the elbow or one of the bones that make up the joint is severely injured or shattered, it may be difficult to put the pieces back together and restore functionality. Moreover, elbow injury can result in damaged ligaments and chronic instability, which can put the patient at risk for dislocations. In these instances, total elbow replacement may be the best option. As for the expected results, quality of life generally improves following the procedure with patients reporting long-lasting pain relief and improvement of their joint’s motion and functionality. Although patients are able to perform activities of daily living without problems, strenuous activities, such as participating in contact sports and lifting heavy objects, may have to be avoided, as these can loosen implant parts that can lead to bone fractures. Recovery after total elbow replacement is approximately 12 weeks.
How is the Procedure Performed?
Total elbow replacement is performed under general anaesthesia. To access the elbow, an incision is made at the back of the joint and the subcutaneous tissue and muscles are retracted while spurs or scar tissues surrounding the joint, if there are any, are gently removed. The humerus (the bone of the arm) and the ulna (one of bones of the forearm) near the elbow joint are then isolated before the stems of the implant are fitted on the humerus and the ulna. The implant is secured in place using bone cement and allowed to harden. Some orthopaedic surgeons advocate adding antibiotics to the bone cement to minimise infection. The muscles are then returned in place and the incision is closed.
After the surgery, the elbow may have to remain flexed for a couple of days to allow the healing of the soft tissues. Once healed, physical therapy and range of motion exercises are performed to strengthen the arm and prevent joint stiffness. Rehabilitation is vital to the success of an elbow replacement.
Possible Risks and Complications
Compared to other joints in the body that are being artificially replaced, the complication rate is highest with the elbow joint. Approximately 25% of elbow implants fail after 5 to 7 years following the procedure with the poor quality of tissues near the joint being one of the main reasons for this failure. Even with medical and technological developments, loosening of the parts of the implant and wearing out of the prosthetic joint can occur after several years. Because of this, total elbow replacement is generally not recommended for young individuals. When failure occurs, bone deficiency, specifically of the ulna, becomes a problem. For cases of elbow replacement failure, additional surgery for revision or to replace certain implant components may be necessary. In some cases, a repeat elbow replacement may have to be performed. However, succeeding elbow replacements are generally not as successful as the first one.
Infection is a dreaded complication of elbow replacement, occurring in less than 10% of patients. Superficial infections affecting only the wound are best treated with aggressive wound care and antibiotic therapy. Deeper infections involving the compartments of the arm or forearm may require repeat surgeries to remove the infected tissues (debridement), or in worst cases, removal of the elbow implant.
The nearby nerves and blood vessels may also be injured during the operation. Some nerve injuries may spontaneously improve through time. When performed properly, these complications are quite rare.
Since the implant is a foreign body, the body may develop adverse reactions or allergies to it or its components. Other complications include dislocation of the elbow, weakness of the tendons of the upper extremity, fracture of the bones particularly the ulna, and joint stiffness.
Reference:
- University of Washington Medical Center: “Total elbow joint replacement for rheumatoid arthritis: A Patient’s Guide.”Sanchez-Sotelo J. The Open Orthopaedics Journal, 2011.
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Very interesting article! #orthopedics #elbowreplacement
Great article, especially for those considering elbow replacement! #helpful