Elbow replacement surgery for arthritis



by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit




The elbow is a hinge joint consisting of three bones.

The upper part of the hinge is at the lower end of the upper arm bone (humerus), and the lower part of the hinge is at the top of the two forearm bones (radius and ulna).

The surfaces of the bones are covered with tough cartilage. Arthritis causes damage to the bone surfaces and cartilage.

Several types of surgery have been used to manage arthritis of the elbow. If the arthritis primarily affects the joint between the lower end of the humerus (upper arm bone) and the head of the radius (one of the forearm bones), removal of the head of the radius can restore function to the elbow.

Joint replacement of the elbow may be of the constrained (hinge) or unconstrained (joint resurfacing) types. For severe rheumatoid arthritis of the elbow, the constrained joint replacement is used because it provides stability and is not dependent on ligaments, which are usually weakened by the arthritis.

Joint replacement surgery is considered when:

1. the arthritis is end-stage,
2. the patient is healthy,
3. there is sufficient bone and tendon to permit the surgery, and
4.the surgeon is experienced in elbow replacement surgery.

The goal of elbow replacement arthroplasty is to restore function to the joint.

In total elbow replacement surgery, an artificial hinge made of metal and plastic is inserted into the joint so that the elbow can move without allowing the two forearm bones to contact the humerus.

The elbow implant consists of two metal stems that are connected by a metal pin. This pin passes through the ends of both stems, which are lined with a strong plastic material that lets the elbow bend.

If necessary, the surgeon adjusts the ligaments around the elbow to get good elbow function.

Recovery of strength and function may take up to a year after surgery.

As with any surgery, elbow replacement carries the risk of infection and bleeding. Also, the metal joint can loosen, which would need to be corrected with another procedure. Injury to the nerves in the elbow is also a possible complication.



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