Total elbow joint replacement for elbow arthritis: Surgery with a dependable, time-tested prosthesis can lessen pain and improve function in elbows, especially in rheumatoid arthritis of the elbow
Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Wednesday, October 28, 2009
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Preparing for surgery
What type of preparation needs to take place before elbow replacement surgery for elbow arthritis?
Total elbow joint replacement surgery is considered for healthy and
motivated individuals in whom rheumatoid arthritis interferes with
elbow function.
Successful elbow joint replacement depends on a partnership between
the patient and the experienced elbow surgeon. The patient's motivation
and dedication are important elements of the partnership. Patients
should optimize their health so that they will be in the best possible
condition for this procedure. Smoking should be stopped a month before
surgery and not resumed for at least three months afterwards. Any
heart, lung, kidney, bladder, tooth, or gum problems should be managed
before surgery. Any infection may be a reason to delay the operation.
The elbow surgeon needs to be aware of all health issues, including
allergies and the non-prescription and prescription medications being
taken. Some of these may need to be modified or stopped. For instance,
aspirin and anti-inflammatory medication may affect the way the blood
clots. The skin of the arm must be clean and free from sores and
scratches.
Before surgery, patients should consider the limitations,
alternatives, and risks of surgery. Patients should also recognize that
the result of surgery depends in large part on their efforts in
rehabilitation after surgery.The patient needs to plan on being less functional than usual for six
to twelve weeks after the procedure. Driving, shopping, and performing
usual work or chores may be difficult during this time. Plans for
necessary assistance need to be made before surgery. For individuals
who live alone or those without readily available help, arrangements
for home help should be made well in advance.
What about the timing of elbow replacement surgery for elbow arthritis? How long can it be safely delayed?
Elbow replacement arthroplasty can be delayed until the time that is
best for the patient's overall well-being. However, in rheumatoid or
other types of inflammatory arthritis, excessive delays can result in
the loss of bone and tendon tissue. These losses can compromise the
quality of the surgery and its result.
How can the costs of elbow replacement surgery for elbow arthritis be anticipated?
The surgeon's office should be able to provide a reasonable estimate
of: (1) the surgeon's fee, and (2) the hospital fee.
How can surgeons experienced in elbow replacement surgery for elbow arthritis be found?
Elbow joint replacement arthroplasty is a technically demanding
procedure that is ideally performed by an experienced surgeon in a
medical center accustomed to performing elbow joint replacements at
least several times a year. Patients should inquire as to the number of
elbow arthroplasty procedures that the surgeon performs each year and
the number of these procedures performed in the medical center each
year.
Because less than several thousand of these procedures are performed
in the United States each year, it is unlikely that every community has
an experienced elbow arthroplasty surgeon who performs many of these
procedures each year. Surgeons specializing in elbow joint replacement
may be located through university schools of medicine, county medical
societies, or state orthopedic societies. Other resources include
local rheumatologists or professional societies such as the American Shoulder and Elbow Surgeons.
Total elbow replacement arthroplasty is usually performed in a major
medical center that performs these procedures on a regular basis. These
centers have surgical teams and facilities specially designed for this
type of surgery. They also have nurses and therapists who are
accustomed to assisting patients in their recovery from elbow
replacement surgery.
Surgery for Elbow arthritis at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington
If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-BONE (2663) to make an appointment. Our clinical center is located in Seattle Washington, USA
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