Elbow Replacement Surgery
Surgical Treatment from an Adelaide Elbow SpeciliastÂ
If your elbow joint is ruined by severe arthritis, a complex fracture, or long-term wear, it can become stiff, painful, and nearly unusable. Elbow replacement surgery, also called total elbow arthroplasty, replaces the damaged joint surfaces with artificial parts made of metal and plastic. Helping restore the elbow's ability to bend, straighten and most importantly relieve you of any pain
Pre-surgical considerations
You might consider this surgery if:
- All conservative treatments—like medications, physio, or injections—no longer relieve your pain or stiffness.
- Severe joint damage is confirmed on X-rays or scans.
- Conditions like osteoarthritis, rheumatoid arthritis, or a badly injured elbow are significantly limiting your daily life.
Before proceeding with elbow replacement surgery, thorough pre-surgical evaluations and considerations are essential. Key elements of this phase include:
Medical evaluation: The orthopaedic surgeon reviews the patient's medical history and conducts a comprehensive physical examination to assess the extent of joint damage and overall health.
Imaging studies: X-rays, MRI, or CT scans are performed to obtain detailed images of the elbow joint, aiding in surgical planning.
Patient education: The surgeon discusses the surgical options, potential risks, and expected outcomes with the patient, allowing them to make informed decisions about their treatment.
Day of surgery considerations
On the day of elbow replacement surgery, the following considerations are made:
Anaesthesia: Patients are administered either general anaesthesia or regional anaesthesia (nerve block) to ensure their comfort and pain management during the procedure.
Surgical procedure: Dr Oscar Brumby-Rendell performs the surgery, making an incision over the elbow joint. The damaged bone and cartilage are removed, and the artificial implant, comprising metal and plastic components, is meticulously positioned to recreate the elbow joint's smooth functioning.
Surgical approach: The surgical approach may be either "triceps on" or "triceps off", with the latter being the classic approach. However, newer techniques involving a "triceps on" approach are gaining popularity due to reduced post-surgery weakness of elbow extension.
Post-surgery rehabilitation
Post-surgery rehabilitation is crucial for achieving successful outcomes after elbow replacement surgery. Key elements of the rehabilitation process include:
Early mobilisation: Gentle range-of-motion exercises are initiated soon after surgery to prevent stiffness and encourage healing.
Strengthening exercises: Progressive strengthening exercises are incorporated to regain elbow strength and stability.
Functional training: Specific activities and exercises are tailored to the patient's needs to help them resume daily activities and achieve optimal function.
Longevity of implant
Advancements in implant designs have contributed to increased implant longevity. The use of linked prostheses has led to a much lower failure rate of elbow replacement. The improved components and fixation techniques have resulted in:
- Reduced wear: Modern materials, such as metal alloys and high-grade polyethylene, have lower wear rates, minimising the risk of implant wear and loosening over time.
- Enhanced stability: Advanced fixation methods, including cementless and cemented options, provide improved stability, leading to a longer-lasting implant.
- Lower revision rates: New elbow replacements have demonstrated lower rates of revision surgery due to their improved designs and better fixation.
Surgical implants and approach
New elbow replacement designs have shown promising results with lower failure rates. Linked prostheses have played a significant role in improving the longevity of elbow replacements, reducing the need for revision surgery.
Surgical approaches
The two main surgical approaches for elbow replacement are "triceps on" and "triceps off". The traditional "triceps off" approach involves detaching and then repairing the triceps tendon, which can result in weakness of elbow extension post-surgery. On the other hand, the "triceps on" approach involves leaving the triceps intact, reducing post-surgery weakness. Although the "triceps on" approach may require slightly more technical expertise, it offers significant advantages in terms of post-surgery recovery and improved elbow function.
Frequently Asked Questions
Post-elbow replacement care with Dr Oscar Brumby-Rendell rehabilitation
Elbow replacement surgery offers an effective solution for patients suffering from severe elbow joint damage. Advancements in implant designs and surgical approaches have contributed to improved outcomes and reduced revision rates. Pre-surgical evaluations, proper rehabilitation, and the use of linked prostheses have played a crucial role in the success of elbow replacements. As medical technology continues to progress, patients can expect even better outcomes and restored elbow function following total elbow arthroplasty.
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