A total elbow replacement or total elbow arthroplasty is not a very common surgery; however, it is successful in relieving joint pain in the elbow after other treatment options have failed to provide relief.
The elbow joint is where three bones in your arm meet to form a hinge joint: the upper arm bone (humerus) and the two bones in your forearm (radius and ulna). Articular cartilage covers the surfaces of the bones where they meet to form the elbow joint.
Cartilage helps protect the bones and allows them to move easily. Additionally, a thin, smooth tissue (synovial membrane) covers the remaining surfaces inside the elbow joint. In a healthy elbow, when you bend and move your elbow the synovial membrane lubricates the cartilage and reduces friction. Additionally, muscles, ligaments and tendons hold the elbow joint together and provide forearm rotation.
- Rheumatoid arthritis: The synovial membrane becomes inflamed and thickened. This causes damage to the cartilage.
- Osteoarthritis: As we age, cartilage can wear away and the bones of the elbow may soften. The bones begin to rub against one another and the elbow joint becomes painful and stiff. This usually occurs in people 50 years and older.
- Post-traumatic arthritis: Follows a serious elbow injury where fractures of the bones that make up the elbow cause damage to the cartilage over time.
- Severe fractures: A severe fracture in one or more of the bones that make up the elbow can be difficult for a physician to repair. If so, a replacement may be necessary.
- Instability: When the ligaments that hold the elbow joint together are damaged, the elbow may become prone to dislocation. This instability is typically caused by an injury.
To determine whether you need a total elbow arthroplasty, your physician will ask you for a complete medical history and when you started experiencing elbow pain, discuss previous treatment methods, have you describe your symptoms and conduct a physical examination. An X-ray or MRI will be necessary for a complete diagnosis.
During a total elbow surgery the damaged parts of the humerus and ulna are replaced with a prosthesis (artificial component). The prosthesis is made up of a metal and plastic hinge with two metal stems. The stems fit inside the hollow part of the bone.
There are a variety of types of elbow replacements and prosthetics come in different sizes. A partial replacement is also an option. Your physician will determine the best option for you.
Recovery from a total elbow replacement
Typically, you will not be allowed to put any weight on your arm or push against with your hand until six weeks after surgery. You will follow a rehabilitation program of exercises and stretching to return your elbow to normal function.
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