Elbow surgeries can be quite the challenge to attempt, because not only is the elbow space complex and vascular, it also requires skillful elbow injury doctors and experience to attempt an elbow repair.
Surgical options are considered only in patients that do not respond to conservative approaches such as over the counter pain medications and physical rehabilitation, and in those individuals who suffer from severe pain and loss of range of motion of the joint.
If you’re anxious about your upcoming elbow surgery, here is a list of the different types of procedures used today by doctors. We will discuss how the operation will happen and what you can expect. Let’s start!
Synovectomy
This surgery involves the removal of the synovium-the membrane lining the joint capsule. In healthy individuals, the synovium produces a thin film of lubricating fluid that nourishes the joint capsule and aids in motion. In rheumatoid arthritis and other forms of inflammatory conditions, the synovium can become inflamed, eroding the cartilaginous surfaces and causing pain and swelling.
A synovectomy is usually indicated to remove the synovium, this temporarily reduces inflammation and improves joint motion. While the procedure is shown to tremendously improve joint swelling and function, with many patients returning to near normal range of motion, the down side to the procedure is that it doesn’t halt disease progression. After the lapse of time, the synovium can eventually grow back and hamper daily life activities.
In most instances, the surgery is repeated once symptoms return. The risk of nerve damage is always present owing to the tight and compact space.
Arthroscopic Elbow Debridement
This procedure is done arthroscopically (through a small cut using an endoscope), in which tiny bone growths along with pieces of cartilage are removed from the elbow cavity.
In some cases, the surgeon may remove pieces of additional surrounding bony areas, such as the radius (a bone in the forearm).
The procedure is commonly indicated in post-traumatic conditions and primary osteoarthritis of the elbow joint. Complete recovery can take up to 3-6 months including the time for rehabilitation.
The surgery is widely indicated for individuals with mild to moderate symptoms of osteoarthritis of the elbow. Patients with advanced disease usually do not benefit from this surgery. While the post-operative results are impressive, with significant improvements in range of motion and pain, bony growths tend to recur which may cause the symptoms to return eventually.
Elbow Interpositional Arthroplasty
The end goal of the procedure is to reshape the ends of the joint capsule, so that the joint surfaces don’t rub against each other causing friction. In this surgery, the ends of the joint are smoothed out and a small section of a soft tissue or the Achilles tendon is placed between the joint surfaces. Recovery time can take up to 4 months, including rehabilitation.
Suitable candidates for the surgery include people suffering from mild primary osteoarthritis of the elbow or post traumatic inflammation. The surgery is indicated in individuals who have a stable elbow joint with intact ligaments for added support. The advantages of the surgery include relief from severe pain and return to near normal function. The bone is also preserved that may permit total elbow replacement in the future if needed.
Total Elbow Replacement
Similar to hip replacement, total elbow replacement involves the replacement of damaged elbow constituents with a synthetic component. A linkable implant is mostly used by surgeons that consists of two metal stems, one in the humerus and the other in the ulna, joined by a metallic hinge that articulates between the two surfaces.
The procedure is life changing for people suffering from severe joint damage due to primary osteoarthritis and post traumatic joint erosion. The maximum recovery time can take up to 3 months. While the procedure promises relief of pain and joint mobility, the implants usually do not last too long and wear out in a couple of years. It is mostly indicated for the elderly population older than 60 years.
While elbow surgical interventions may seem daunting, it’s important to address your concerns with your orthopedic elbow specialist McLean beforehand. Try to be fully prepared for the procedure physically and mentally. It will help you go through the process. Good luck!