Elbow replacement is a surgical procedure to replace a diseased elbow joint with an artificial joint. While rest, medications, physical therapy etc can help in majority of cases, certain situations warrant an elbow replacement. It can never be the first line of treatment. If done, the aim of surgery is to get rid of pain and to improve mobility to a small extent.
Causes of Elbow Pain & Disability
Rheumatoid Arthritis (Inflammatory Arthritis) in which the synovial membrane surrounding the joint inflames and thickens resulting in cartilage damage and causing cartilage loss, pain, and stiffness.
Osteoarthritis (Degenerative Joint Disease) is an age-related, "wear and tear" arthritis that usually occurs in people 50 years of age and older, but may hit youngsters too. The cartilage that cushions the bones of the elbow softens and wears away. The bones then rub against one another. Over time, the elbow joint becomes stiff and painful.
Post Traumatic Arthritis can follow a serious elbow injury. Fractures of the bones that make up the elbow, or tears of the surrounding tendons and ligaments may cause damage to the articular cartilage over time causing pain and delimiting elbow function.
Severe Fracture is another common reason people have elbow replacements. If the elbow is shattered, it may be very difficult for a doctor to put the pieces of bone back in place. In addition, the blood supply to the bone pieces can be interrupted. Thus, a surgeon may recommend an elbow replacement. Older patients with osteoporosis (fragile bone) are most at risk for severe elbow fractures. In addition, some fractures do not heal well and require an elbow replacement.
Instability occurs when the ligaments that hold the elbow joint together are damaged and do not work well. Over time, elbow is prone to dislocation. Chronic Instability is most often caused by an injury.
Types of Elbow Replacement
There are different types of elbow replacements. Components are available in different sizes.
- Total Elbow Replacement
- Partial Elbow Replacement
In Total Elbow Replacement surgery, the damaged parts of the humerus and ulna are replaced with artificial components. The artificial elbow joint is made up of a metal and plastic hinge with two metal stems. The stems fit inside the hollow part of the bone called the canal.
Your doctor will help to determine the type of best elbow replacement.
Pre Surgery Medical Evaluation
- A complete physical examination with your family physician several weeks before surgery shall be recommended to evaluate if you are healthy enough to undergo the surgery and recover.
- Patients with chronic medical conditions like heart disease, must additionally be evaluated by a specialist, such as cardiologist before surgery.
Some medications may need to be stopped pre surgery in consultation with your Doctor. For example, the following over-the-counter medicines that may cause excessive bleeding and should be stopped 2 weeks prior surgery:
- Non-steroidal anti-inflammatory medications, such as aspirin, ibuprofen, and naproxen sodium.
- Most arthritis medications.
- Blood thinners.
Elbow Replacement Procedure
To reach the elbow joint, Surgeon will make an incision (cut), usually at the back of the elbow. Later your surgeon will gently move muscles aside to get access to the bone. After removing scar tissue and spurs around the joint, your surgeon will prepare the humerus to fit the metallic piece that will replace that side of the joint. The same preparation is done for the ulna.
The replacement stems are placed into the humerus and ulna bones, and kept in place with a bone cement. The two stems are connected by a hinge pin. After the wound is closed, a padded dressing is then placed to protect the incision while it recuperates.
Antibiotics shall be prescribed to prevent infection. Most patients are able to eat solid food and get out of bed the day after surgery. You will most likely stay at the hospital 2 to 4 days post surgery.
After surgery, you will feel some pain. This is a natural part of the healing process. Medications are often prescribed for short-term pain relief after surgery.
A careful, well-planned rehabilitation program is critical to the success of an elbow replacement. You will be taught some exercises for your hand and wrist to avoid stiffness and help to control swelling. You will do gentle elbow range-of-motion exercises as the incision heals. Your doctor may prescribe therapy or may teach you how to do the exercises yourself.
You will most likely not be allowed to put any weight on your arm or push against resistance with your hand until about 6 weeks after your surgery.
- Infection may occur in the wound or deep around the artificial components. It may even occur years later. Any infection in your body too can spread to your joint replacement. Minor infections are generally treated with antibiotics while Major or deep infections may require more surgery and removal of the components.
- Implant Problems: The implant may wear down and the components may loosen. The plastic\ liner (called the bushings) can wear out, and may need to be replaced. Excessive wear, loosening, or implant breakage may require additional surgery (called a revision procedure).
- Nerve Injury is infrequent but possible. Over time, these nerve injuries typically improve without needing treatment.
Carefully protect your incision to avoid wound healing problems.
Life After Elbow Replacement Surgery
The majority of patients have experienced an improved quality of life after total elbow replacement surgery. They experience less pain, improved motion and strength, and better function.
You should expect to do all basic activities of daily living, such as getting a plate out of a cabinet, cooking dinner, lifting a milk jug, styling your hair, basic hygiene, and dressing. Talk to your doctor about activities you may want to avoid, such as contact sports and activities with a major risk of falling (such as horseback riding or climbing ladders), as well as heavy lifting.
India is becoming the most preferred healthcare destination globally.
India has lot of good hospitals with most modern facilities and very eminent joint replacement surgeons.
The elbow replacement surgery in India is much lower priced compared to many other developed countries. Research is being done in the area of implant design in order to make the replacement components last as long as possible.
Elbow Replacement Surgery in India is performed through cutting- edge clinical solutions, research, extraordinary patient care and infrastructure of world-class standards. Elbow Replacement Surgery is a complex surgical exercise and needs highly skilled consultants, ingenious technical staff and advanced technology working with perfect harmony, enormous dedication and team work. India offers a one stop solution for all those seeking critical procedures such as Elbow Replacement Surgery.