What Is a Total Elbow Replacement?
The elbow is a meeting of three bones: the humerus (upper arm bone), the radius (inside forearm bone) and the ulna (outside forearm bone). A total elbow replacement—also known as a total elbow arthroplasty—involves replacing parts of the humerus and ulna with metal stems and connecting them with a hinge.
Common Reasons for a Total Elbow Replacement
Damage to the elbow due to arthritis —specifically rheumatoid arthritis and post-traumatic arthritis—is one of the main reasons for an elbow replacement. Other reasons include severe fractures and elbow instability—damage to the ligaments that increases the risk of elbow dislocation. Osteoarthritis of the elbow is generally treated either conservatively or with an arthroscopic or open procedure to remove bone spurs, loose material and debris.
Candidates for Total Elbow Replacement
Candidates for total elbow replacement include people who have had a severe fracture of one or more bones of the elbow that cannot be realigned (reduced), and people with severe rheumatoid arthritis symptoms who have not responded to more conservative treatments like anti-inflammatories, corticosteroid injections or physical therapy.
The surgeon first makes an incision at the back of the elbow and moves muscles and other tissue to the side to access the bones. Next, any scar tissue and bone spurs are removed. Then, the surgeon attaches metal stems with a hinge on the end to the humerus and the ulna. Finally, the incision is closed with stitches or staples.
A short hospital stay of about one to four days is usually necessary after total elbow arthroplasty. There will be pain after the surgery, which can be controlled with anti-inflammatories and painkillers. Antibiotics are necessary to prevent infection.
Rehabilitation is a crucial aspect of the healing process. The first aspect will be hand and wrist exercises to prevent swelling from the surgery. Next, gentle exercises to increase the elbow’s range of motion will be introduced. The surgeon and medical staff may recommend physical therapy or provide a home exercise program.
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