Elbow Joint Replacement
Elbow can also be affected by osteo or rheumatoid arthritis. Elbow joint replacement can effectively treat the problems caused by arthritis of the elbow. The procedure is more widely used in aging adults to replace joints damaged by fractures. In elbow replacement surgery, the painful surfaces of the damaged elbow are replaced with artificial elbow parts. One part fits into humerus (arm bone) and another part fits into ulna (strongest bone in the forearm). The two parts are then connected and held together by a pin. The resulting hinge allows the elbow to bend.
Elbow & Wrist Joint Replacement
About Elbow Replacement Surgery
Elbow replacement surgery is usually done to replace the bones of the elbow joint with artificial joint parts.
The elbow joint connects two bones:
- The humerus in the upper arm
- The ulna in the lower arm
The artificial elbow joint has two stems made of high-quality metal. A metal and plastic hinge joins the stems together and allows the artificial joint to bend. Artificial joints come in different sizes to fit people of various sizes.
You may receive general anesthesia before surgery. This means you will be asleep and pain-free during surgery. Some patient may receive regional anesthesia instead, and will be awake, but their arm will be numb and they will not feel pain. Patients on regional anesthesia will also be given medicine to help relax during the operation.
The Procedure
- The surgeon will make a surgical cut on the arm to reveal the elbow joint. Usually this is made in the back of the upper and lower arm
- Damaged tissue and parts of the arm bones that make up the elbow joint are removed
- A drill is used to make a hole in the center of the two arm bones. The end of the artificial elbow joint stems are placed into each bone. The two stems are attached together with a hinge
- The wound is closed with stitches, and a bandaged is applied. Your arm may be placed in a splint to keep it stable
Why Elbow Replacement Surgery?
Elbow replacement surgery is usually done if the elbow joint is badly damaged and you have pain or cannot use your arm. Some causes of damage are:
- Osteoarthritis
- Poor outcome from previous elbow surgery
- Rheumatoid arthritis
- Fracture of the upper or lower arm near the elbow
- Badly damaged or torn tissues in the elbow
- Tumor in or around the elbow
The Risks
The risks for any anesthesia are:
- Allergic reactions to medicines
- Breathing problems
The risks for any surgery are:
- Bleeding
- Blood clot
- Infection
Additional risks of elbow replacement surgery are:
- Allergic reaction to the artificial joint
- Blood vessel damage during surgery
- Bone break during surgery
- Dislocation of the artificial joint
- Loosening of the artificial joint over time
- Nerve damage during surgery
The Result
Elbow replacement surgery eases pain for most people. A second elbow replacement surgery is usually not as successful as the first one.
Patient Guidelines
Always tell your doctor or nurse what drugs you are taking, including drugs, supplements, or herbs you bought without a prescription.
During the 2 weeks before your surgery:
- You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen and Naproxen
- Ask your doctor which drugs you should still take on the day of your surgery
- If you have diabetes, heart disease or other medical conditions, your surgeon will ask you to see your doctor who treats you for these conditions
- Tell your doctor if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day
- If you smoke, try to stop. Ask your doctor or nurse for help. Smoking can slow down wound healing.
- Tell your doctor if you develop a cold, flu, fever, herpes breakout, or other illness before your surgery.
On the day of your surgery:
- You will usually be asked not to drink or eat anything for 6 to 12 hours before the procedure
- Take the medicines your doctor told you to take with a small sip of water
- Arrive at the hospital at the time your health care provider told you to do so
- You may stay in the hospital for up to 2 or 3 days
- You may have a splint on your arm to help stabilize your elbow
- Your doctor will prescribe physical therapy to help you gain strength and use of your arm. Physical therapy will start with gentle flexing exercises. People who have a splint usually start therapy a few weeks later than those who do not have a splint
- Some people may start to have use of their new elbow as soon as 12 weeks after surgery. Complete recovery can take up to a year
Wrist Joint Replacement (Wrist Arthroplasty)
Joint replacement surgery in the wrist is much less commoner than knee and hip replacement but can be an option if you have painful arthritis that does not respond to other treatment.
About the Wrist
The wrist is a more complicated joint than the hip or the knee. On the hand side of the wrist, are two rows of bones at the base of the hand. There are four bones (called carpals) in each row. The long thin bones of the hand radiate out from one row of carpals and form the basis of the fingers and thumb.
The radius and the ulna are the two bones of the forearm that form a joint with the first row of carpals. The ends of the bones are covered with an elastic tissue, called cartilage. Cartilage creates a slick surface that enables the bones to move smoothly when they move against each other.
Why Wrist Joint Replacement Surgery?
If the cartilage is worn out or damaged by injury, infection, or disease, the bones themselves will rub against each other, wearing out the ends. This causes a painful, arthritic condition.
- Osteoarthritis, the most common form of arthritis, results from a gradual wearing away of the cartilage covering on bones
- Rheumatoid arthritis is a chronic inflammatory disease of the joints that results in pain, stiffness and swelling. Rheumatoid arthritis usually affects several joints on both the right and left sides of the body
Both forms of arthritis may affect the strength of the fingers and hand, making it difficult to grip or pinch.
The typical candidate for wrist replacement surgery has severe arthritis but does not need to use the wrist to meet heavy demands in daily use. The primary reasons for wrist replacement surgery are to relieve pain and to maintain function in the wrist and hand. Strength and powerful grip do not result from wrist replacement surgery.
The Result
Wrist replacement surgery may help retain or recover wrist movement. It may also improve the ability to perform daily activities, especially if there is arthritis in the elbow and shoulder. During any total joint replacement, the worn-out ends of the bones are removed and replaced by an artificial joint (prosthesis).