The elbow is a pivotal articulation composed of three essential bones: the humerus, ulna, and radius. These bone extremities are sheathed in cartilage, a flexible tissue that facilitates smooth joint movement and acts as a shock absorber. Ligaments serve as the connecting elements that conjoin these bones, thereby forming the joint capsule. This joint capsule, in turn, is filled with synovial fluid, which envelops and lubricates the elbow, ensuring its optimal functionality.
Elbow replacement surgery is a procedure designed to address severely damaged joint surfaces within the elbow joint.
The destructive damage to the elbow joint (caused by age-related conditions or diseases of the elbow) resulting in elbow replacement surgery is less common when compared to knee, hip and shoulder replacement surgeries.
This is the type of surgery suggested when both ends of the arm bone (humerus) and the forearm bone (ulna), which contribute to the formation of the elbow joint, are severely and irreparably damaged.
This type of elbow replacement is reserved for unstable elbow joints where a “hinge” is used to link the two surfaces of the replaced elbow and innate stability is achieved by the “hinge” and not from the elbow's own ligaments, which have failed to provide stability to the elbow which is often seen in cases such as post-traumatic ligament injuries when multiple ligament injuries to the elbow have been treated inadequately or have failed following attempts at repair following the damage to ligaments.
Like all other conditions/ diseases and joints, the elbow/ joint replacement surgery should and will only be considered when all other modalities of conservative management (ice packs, pain killers (in moderation), physiotherapy and rehabilitation have failed or produced satisfactory results in patient needs.
Also, The age of the individual plays a significant role during consideration for elbow replacement. Age groups below 50 to 60 years of age are rarely recommended elbow replacement surgery due to the higher physical demand from their elbow of younger individuals and the limited longevity of elbow replacement prosthesis. Only under exceptional circumstances will an elbow replacement surgery be suggested for individuals belonging to age groups under 50 to 60 years.
The commonest indications (requirement) for elbow replacement surgeries are those who suffer from one of the (but not limited to) the following conditions:
Technological advancements in the field of joint replacement surgeries as a whole, especially elbow replacements, have made it a very safe and patient-friendly procedure.
Elbow surgeries are carried out by skilled orthopaedic surgeons committed to ensuring patient safety. While all surgeries entail some level of risk, advances in medical technology have greatly enhanced the safety and effectiveness of elbow procedures.
Recovery times after elbow surgery are variable and depend on factors such as the type of procedure, an individual's health, and their adherence to post-operative instructions. In many cases, minimally invasive approaches lead to faster recoveries, enabling patients to resume regular activities more swiftly.
Consultation with your joint replacement surgeon involves meeting with Dr. Balaji Subramanian. During this consultation, you will discuss how your elbow problem developed and the specific demands or requirements you have for your elbow. Dr. Balaji Subramanian will conduct a comprehensive physical examination. Based on your information and his examination, the need to assess the extent of joint damage will be determined. This assessment will be done through an appropriate form of radiological imaging, which will be selected based on your specific needs.
Simple X-ray of the elbow: The most basic form of imaging modality to visualise the elbow joint is the X-ray. Many (but not all) details can be obtained from viewing an X-ray. Note: An X-ray primarily reveals the bone and provides limited details. For a more comprehensive examination of the bone and the ligaments surrounding the elbow, a CT scan or an MRI scan of the elbow may be necessary.
X-ray showing severe destruction of the right elbow joint in a patient with rheumatoid arthritis.
After obtaining the necessary details, the various options, benefits and limitations (if any) will be discussed with you.
This is our preferred type of anaesthesia for upper limb surgeries and involves an injection for the upper limb on which the elbow surgery is going to be performed. This type of anaesthesia is safe and accurate, requires minimal use of any anaesthetic agent and, most importantly, continues to provide a pain-free experience for the patient even several hours after the surgery. Also, in this form of anaesthesia, the patient can be awake throughout the surgery with complete numbness of the limb through the entire duration of the procedure, providing a very safe and painless intra-operative experience for the patient.
It is the type of anaesthesia where the patient is fully anaesthetised during the surgery. The patient will be awakened by the completion of the surgery when they are ready to be shifted out of the operating theatre.
You may be required to stay in the hospital for a few days to provide adequate pain relief, monitor the progress of the operated elbow and begin physical rehabilitation exercises to help you achieve peak performance with your new functional elbow.
