According to the American Academy of Orthopaedic Surgeons (AAOS), total joint replacement (TJR) is one of the most common surgical procedures done in the US. The most common type of total joint replacement is total knee replacement. Elbow replacements are less common, but many people suffering from arthritis or an injury to the elbow get them each year.
Joint replacement can help relieve pain, restore joint function, and improve mobility. Surgery is usually only recommended if you’ve already tried medication and other nonsurgical treatments. If you have elbow pain that is interfering with your daily life and other treatments haven’t helped, you may be a candidate for elbow replacement surgery. But before you make the decision to have surgery, here are five things you should know.
1. Elbow Replacement is an Effective Arthritis Treatment
The procedure was initially developed as a treatment for rheumatoid arthritis (RA). RA is an immune disorder in which the body attacks its own healthy tissue in the joints. This causes pain, stiffness, and loss of mobility. Patients with RA usually have damage and inflammation in multiple joints, including the elbows. Another type of arthritis elbow replacements are used to treat is psoriatic arthritis, another autoimmune disease that has symptoms that are similar to those of RA.
Osteoarthritis, or “wear-and-tear” arthritis, can also be treated with a joint replacement if nonsurgical treatments have failed to produce good results. However, osteoarthritis is seen more often in weight-bearing joints like the hips and knees than in the elbows.
2. But It’s Not Just for Arthritis
Over the years, the medications that are used to treat RA and psoriatic arthritis have become more advanced and effective. When patients get significant relief from nonsurgical treatment, then surgery is not recommended. That means fewer elbow replacements are done to treat arthritis. Now the procedure is more commonly used to treat bone fractures near the elbow. These fractures are more common in older adults who may have experienced bone loss or osteoporosis.
3. Elbow Replacement Can Be Done Two Ways
Elbow replacements can be done with a linked or unlinked implant. Most procedures in the United States are linked.
- Linked implant: A metal stem is implanted, or anchored, in the upper arm bone (the humerus). Another metal stem is implanted in the ulna, which is one of the two bones in the forearm. After the implants are cemented in place, the stems are connected with a hinge in the elbow.
- Unlinked implant: The two implants are placed the same way as they are in the linked procedure. However, they are not connected with the hinge. They are held in place with the muscles, ligaments, and other natural parts of the elbow.
There are drawbacks and advantages to both types of replacement. The hinge in the linked implant may become stretched and loose over time. That’s why there are lifting restrictions after surgery. An unlinked implant requires the ligaments, muscles, and tissues of the elbow to be in good shape. If they are damaged, then the joint will be unstable. Physical therapy is a critical part of keeping the muscles and tissues strong and stable.
4. It’s Recommended for Older Adults
While elbow replacement is used for conditions other than age-related arthritis, it is still recommended mostly for older patients. That’s because the implants used in the procedure will not hold up for decades in a younger patient. Another reason younger people don’t usually get this kind of joint replacement surgery is the permanent lifting restriction. No matter the age of the patient, joint replacement is usually only recommended after nonsurgical methods have been unsuccessful.
5. Advancements Are Still Being Made
Even though patients experience good results with current procedures, people are still working to improve outcomes. Implant designs are being developed and tested. Some innovations include a convertible implant that can be unlinked at first and then linked later if the joint requires more stability. There are even partial replacements being developed that would only require an implant in either the humerus or the ulna instead of both.
The team at South Shore Orthopedics is dedicated to helping our patients lead active lives. Our board-certified physicians have experience in a number of orthopedic specialties including joint replacement. If you have concerns about your joint health or an injury, call our office at (781) 337-5555 to make an appointment