Elbow arthroplasty (elbow joint replacement) is a more recent and much less common operation.
However, Israel is considered to be a country where accumulated years of experience in elbow replacement. This allows our surgeons to perform it at a high level. This operation may be performed only by a highly specialized physician who regularly operates the elbow using advanced replacement technology. Operation to replace the elbow joint is performed in cases where other measures medical and surgical do not bring satisfactory results.
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Basic pathology of the elbow joint which can lead to elbow arthroplasty are as follows:
- Arthritis
- Rheumatoid Arthritis
- Complicated elbow fracture, including that in old age
- Severe damage or break the soft tissues of the elbow
- Malignancies in joint or around the elbow
- Negative results of previous surgery on the elbow
Standard preoperative test includes: and X-ray of elbow, blood test, ECG and chest X-ray (in patients older than 40 years). For hemophiliacs measures to improve the rate VIII is important.
The surgery usually takes one to two hours and is performed under general anesthesia. In some cases also used regional anesthesia.
The incision is carried out, as a rule, on the rear side for opening the elbow. Surgeon removes the lower end of the humerus and the upper end of the ulna together with the damaged tissue. Then, in the central part of the humerus and the ulna installed kernels and cemented prosthesis. Two bases are connected with hinge mechanism. The wound is closed and hand is superimposed on the tire for fixing and stabilizing the prosthesis. Sometimes surgeons use a plaster bandage which is typically removed from 48 to 72 hours.
As with any surgery there is a possibility in complications: bleeding, infection, thromboembolism (rare in surgery of the upper extremity).
Postoperative management
The patient will stay in hospital for about three or four days. A splint may be used after surgery to help stabilise the elbow.
Physiotherapy begins with light exercise. Patients who have a splint typically start therapy a few weeks later than those who do not. During the first 6 weeks after surgery the patient will need assistance in daily activities (driving , shopping, taking a bath, cooking and housework).
In some patients elbow function recovery begins with 12 weeks after surgery although complete recovery may take up to one year.
After the restoration of function patient should not lift more than 2.5 kg of the operated hand, even if it is fully recovered.
Prosthesis
Elbow prosthesis personally determined by a surgeon based on the pictures and the anatomical structure of joint.
The most commonly used prostheses unrelated Kudo and Souter-Strathclyde, and related prostheses Coonrad-Morrey, Gschwend and Discovery. Practice shows that the linked hinge implants better reduced arc motion, which promotes faster recovery and a lower level of radiological loosening.
