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Elbow Replacement in India
Elbow joint replacement (also called elbow arthroplasty)
Elbow Replacement Surgery, Elbow Replacement, Elbow, Relive Pain
Anatomy
How does the elbow joint work?s
The elbow joint is made up of three bones: the humerus bone of the upper arm, and the ulna and radius bones of the forearm.
The ulna and the humerus meet at the elbow and form a hinge. This hinge allows the arm to straighten and bend. The large triceps muscle in the back of the arm attaches to the point of the ulna (the olecranon). When this muscle contracts, it straightens out the elbow. The biceps muscles in the front of the arm contracts to bend the elbow.
Inside the elbow joint, the bones are covered with articular cartilage. Articular cartilage is a slick, smooth material. It protects the bone ends from friction when they rub together as the elbow moves. Articular cartilage is soft enough to act as a shock absorber. It is also tough enough to last a lifetime, if it is not injured.
The connection of the radius to the humerus allows rotation of the forearm. The upper end of the radius is round. This round end turns against the ulna and the humerus as the forearm and hand turn from palm down (pronation) to palm up (supination)
Rationale
What makes elbow joint replacement surgery necessary?
A joint replacement surgery is usually considered a last resort for a badly damaged and painful elbow joint. The artificial joint replaces the damaged surfaces with metal and plastic that are designed to fit together and rub smoothly against each other. This takes away the pain of bone rubbing against bone.
The most common reason for an artificial elbow replacement is arthritis. There are two main types of arthritis, degenerative and systemic. Degenerative arthritis is also called wear-and-tear arthritis, or osteoarthritis. Any injury to the elbow can damage the joint and lead to degenerative arthritis. Arthritis may not show up for many years after the injury.
There are many types of systemic arthritis. The most common form is rheumatoid arthritis. All types of systemic arthritis are diseases that affect many, or even all, of the joints in the body. Systemic arthritis causes destruction of the joints' articular cartilage lining.
An elbow joint replacement may also be used immediately following certain types of elbow fractures, usually in aging adults. Elbow fractures are difficult to repair surgically in the best of circumstances. In many aging adults, the bone is also weak from osteoporosis. (People with osteoporosis have bones that are less dense than they should be.) The weakened bone makes it much harder for the surgeon to use metal plates and screws to hold the fractured pieces of bone in place long enough for them to heal together. In cases like this, it is sometimes better to remove the fractured pieces and replace the elbow with an artificial joint.
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Preparation
What do I need to know before surgery?
You and your surgeon should make the decision to proceed with surgery together. You need to understand as much about the procedure as possible. If you have concerns or questions, you should talk to your surgeon.
Once you decide on surgery, you need to take several steps. Your surgeon may suggest a complete physical examination by your regular doctor. This exam helps ensure that you are in the best possible condition to undergo the operation.
You may also need to spend time with the physical or occupational therapist who will be managing your rehabilitation after surgery. This allows you to get a head start on your recovery. One purpose of this pre-operative visit is to record a baseline of information. Your therapist will check your current pain levels, ability to do your activities, and the movement and strength of each elbow.
A second purpose of the pre-operative therapy visit is to prepare you for surgery. You'll begin learning some of the exercises you'll use during your recovery. And your therapist can help you anticipate any special needs or problems you might have at home, once you're released from the hospital.
On the day of your surgery, you will probably be admitted to the hospital early in the morning. You shouldn't eat or drink anything after midnight the night before. Come prepared to stay in the hospital for at least one night.
Surgical Procedure
What happens during an elbow replacement surgery?
Replacement surgery is usually not considered until it has become impossible to control your symptoms without surgery. If replacement becomes necessary, it can be a very effective way to take away the pain of arthritis and to regain use of your elbow.
Before we describe the procedure, let's look first at the artificial elbow itself.
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The Artificial Elbow
There is more than one kind of artificial elbow joint (also called a prosthesis). The most common types are like a hinge.
Each prosthesis has two parts. The humeral component replaces the lower end of the humerus in the upper arm. The humeral component has a long stem that anchors it into the hollow center of the humerus. The ulnar component replaces the upper end of the ulna in the lower arm. The ulnar component has a shorter metal stem that anchors it into the hollow center of the ulna.
