The elbow replacement surgery is essentially an operation, in which the affected areas of the ulna and the humerus are substituted with the right prosthesis. The prosthesis is usually made of a metal, having a plastic hinge with a couple of metal stems. The stems are supposed to fit inside the hollow part of the bone, which is called a canal.
There are three types of elbow replacement surgeries:
- Total, in which the complete joint is replaced with a prosthesis
- Partial, which is done only if certain parts of the joint are to be taken care of
- Revision, which is conducted to address the problems caused after the primary surgery
Causes: Various reasons can lead to pain and disability of the elbow.
Following are the most popular cases which lead to an elbow replacement surgery:
- Rheumatoid arthritis: In this condition, the synovial membrane surrounding the shoulder joint gets inflamed and thickened. This can lead to the cartilage being damaged, and causing pain, stiffness, and cartilage loss. This arthritis is one of the most popular groups of disorders known as “inflammatory arthritis.”
- Osteoarthritis (Degenerative Joint Disease): This condition occurs mostly due to age. It is a typical “wear and tear” kind of arthritis. Usually, people older than 50 years of age face this situation. What happens is, that the cartilage which is cushioned between the bones of the shoulder becomes soft and wear away. Eventually, the bones rub against one another, leading to immense pain and stiffness. Sadly, no ways have been found to prevent osteoarthritis, as of now.
- Post-traumatic Arthritis: This is known to follow a serious shoulder injury. The bones which make up the shoulder are fractures, or the shoulder tendons tear. Ligaments damaging the articular cartilage with time can also lead to post-traumatic arthritis. Pain and limited movement of the shoulder are the indications.
- Severe Fractures: A serious fracture of one or more bones, which are a part of the elbow, will lead to an elbow replacement surgery. Older people having osteoporosis (fragile bone) have a higher risk of severe elbow fractures.
- Instability: This happens when the ligaments, which support the elbow joints, get damaged and do not perform properly. This increases the chances of elbow dislocation. Chronic instability is often a result of a serious injury.
Evaluation and treatment: The orthopaedic surgeon may recommend a complete physical evaluation to understand the root of the problem. The physical examination also ensures if the patient is healthy enough to undergo the surgery and recover without hassles. Talk to the doctor about the on-going medications, if any, and if you need to stop their intake before the surgery.
It would be wise to make some small changes at home, which will help you to cope with the shoulder during the recovery period. Place important items on lower shelves, and hire help for your daily work like cooking, laundry, dressing, etc.
During the surgery, small incisions are made by the doctor behind the elbow. To gain access to the bone, the surgeon will move the muscles gently. Then, the humerus is prepared to fit the prosthesis, which replaces that side of the joint. The same is done for the ulna. To keep the replacement stems in the ulna and humerus bones, bone cement is used. The dressing of the wound is done for protecting the incision while the healing process kick-starts.