CONDITIONS TREATED

Elbow Joint Replacement

Location

The natural hinging and rotation of the elbow joint is made possible by the muscles being able to move the three bones that meet at the elbow joint smoothly and without friction. The articular cartilage that provides this essential shock absorber and lubricant, once damaged, may lead to progressively painful joint damage. Elbow arthroplasty - joint replacement surgery - replaces the damaged surfaces with a metal and plastic joint.

Symptoms

The most common reason for elbow arthroplasty is arthritis, either through the wear-and-tear of aging (osteoarthritis) or systemic disease such as rheumatoid arthritis, which causes breakdown in the articular cartilage lining the joints. Elbow joint replacement may also be best following elbow fracture in an elderly patient as many will have weakened bones as a result of osteoporosis, making fracture repair and healing very difficult.

Diagnosis

Following an initial physical examination and review of personal medical history, diagnostic imaging using MRI scan, x-ray or CT scan will aim to confirm the cause of the deterioration in the elbow joint and best course of action. Once surgery has been scheduled, it may be advisable for a physical or occupational therapist to review the patient to establish a baseline of abilities, pain levels and current movement and strength of the elbow. This will help to plan rehabilitation following surgery.

Treatment

The most commonly fitted prosthetic elbow joint replaces the lower end of the humerus with a hinge joint. During surgery an incision is made in the back of the elbow joint to avoid most of the blood vessels and nerves that are on the inside of the elbow. The tendons, ligaments and ulnar nerve are then eased aside to expose the joint. The joint surfaces of the ulna and the radius are then removed, and the marrow space within the ulna hollowed out to receive the metal stem of the ulnar component. The surgeon then repeats the procedure on the humerus and the two bones then prepared for fixing in place of the prosthetic hinge, either with epoxy cement or a fine mesh which anchors bone regrowth.