About the elbow joint
The elbow joint consists of the lower end of the humerus and the upper ends of the ulna and radius, including the humero-ulnar joint, the humero-radial joint and the proximal radial-ulnar joint, and is enclosed in a common joint capsule. The capsule is surrounded by ligaments, synovial bursae, and muscles that support, protect, and move the joint.
The range of motion of the elbow joint
The main activities of the elbow joint are extension and flexion and anterior and posterior rotation of the forearm. Elbow joint extension and flexion cannot be replaced by other joint movements and are indispensable to human function. By flexing and extending the elbow joint, objects held in the hand can be sent to the head and torso; grasping certain objects with the hand can push the body upward, away or close; the forearm can be bent for defense or attack. Normal elbow function is 150-160° of flexion, 5-0° of extension, 15° of hyperextension, and 80-90° each of rotation forward and backward. Biomechanical studies have shown that the most common daily activities require only 30-130° of extension and flexion and 50° of anterior-posterior rotation each.
What is artificial elbow joint replacement surgery?
An artificial elbow joint is used to replace a damaged elbow joint. One part of the artificial elbow joint prosthesis is fixed in the humerus of the upper arm, and the other part of the prosthesis is fixed in the ulna of the forearm. The two parts are then connected in bearings to allow for flexion of the artificial elbow joint.
How Patients Can Prepare for Artificial Elbow Replacement Surgery
If you and your surgeon decide that you should have an artificial elbow replacement, a date will be scheduled for the surgery. For example, the surgeon will ask you to undergo a physical examination to ensure that some of your other health problems (such as high blood pressure) are detected and treated prior to surgery. In addition, the surgeon will inform you about the preoperative preparation and postoperative rehabilitation.
What will happen during your elbow replacement surgery?
On the day of surgery, an intravenous line will be set up in your healthy arm to ensure that the medications and fluids needed during surgery are replenished. You will then be taken to the operating room and given anesthesia, after which your elbow joint will be cleaned and disinfected. At the beginning of the procedure, an incision will be made in the elbow joint to expose the internal structures of the elbow joint. Through precise instrumentation, the lower humerus (upper arm bone) and upper ulna (lower arm bone) will be removed and set up for the internal placement of the artificial elbow joint. The artificial elbow joint will then be inserted and fixed with a special bone cement. The two parts of the artificial elbow joint will be fixed with pins. When the surgeon is satisfied with the fixation and function of the artificial elbow joint, the surgical incision will be closed and covered with a sterile dressing. The surgery usually takes one to three hours, depending on the severity of your elbow lesion.
After dressing the wound with a sterile bandage, you will be taken to the monitoring room for close supervision. Your arm may be immobilized in a splint or cast, or wrapped in an ice pack to relieve pain and swelling, and you will be given pain medication. When you wake up, you will be taken back to your room.
What happens after surgery
When you are returned to your room, you will begin a rehabilitation program to help relax the muscles around the artificial elbow. The nurse will encourage you to cough and breathe deeply to help your lung function recover. You will be encouraged to get up and take a few steps, and you will receive continuous analgesia as needed. The bandage on your arm will be removed two days after surgery. Before you leave the hospital, your doctor will show you how to perform some important rehabilitation exercises.
How long it takes to return to normal activities after surgery
A successful elbow replacement will relieve the pain and stiffness in your elbow joint and allow you to resume your daily activities under the direction of your doctor. After you have recovered, you should not lift more than one kilogram on the upper arm of the operated side. Even after you have fully recovered, there are still some restrictions. Patients who have undergone elbow arthroplasty should not participate in contact sports, hammering, repetitive lifting, or excessive flexion and extension of the elbow joint after surgery. Your doctor recommends that you do not lift anything heavier than 5 pounds on the upper extremity of the operated side. Although it is possible to reattach the artificial elbow joint, the second surgery will rarely be more effective than the first.
How long does an artificial elbow joint last?
The life span of an elbow prosthesis is individual and depends on many factors (such as the patient’s physical condition and activity level, as well as the precise placement of the prosthesis during surgery). It is important to clarify that the artificial elbow joint is certainly not as strong as a healthy elbow joint, and its lifespan is not yet guaranteed to be with the patient for the entirety of his or her life.
Elbow replacement can reduce pain and improve the function of the elbow joint. As a result, some patients may have unrealistic expectations about what activities the artificial elbow joint can perform and how much activity it can withstand. Like many other artificial joints, the parts of the artificial elbow device move and rub against each other, and the synovial fluid fills the joint space and serves as a lubricant, just as it does in a natural joint. However, the parts of the prosthesis will wear as they roll or slide, just like the tires or brakes of a car, and the rate of wear depends in part on how the artificial elbow joint is used. A large portion of the pressure on the elbow joint prosthesis is exerted during elbow motion, and the life of the artificial elbow joint will be reduced in patients who have too much elbow motion. Loose and worn prostheses sometimes require revision surgery to replace worn parts or the entire prosthesis. Your surgeon will discuss these issues with you at the appropriate time, choose the type of prosthesis for your particular case, and advise you on the lifestyle you will need to lead after surgery.
Talk to your surgeon about the following points, which will directly affect the success of your artificial elbow replacement surgery and the longevity of your elbow prosthesis.
1. Avoid repeated lifting of heavy objects; avoid lifting anything heavier than one pound during the recovery period; avoid lifting anything heavier than five pounds after the recovery period.
2, avoid hammering and other “disturbing” activities.
3, avoid boxing and other activities with “impact loading”.
4, when starting a new sport or activity, consult with your doctor to determine the type and intensity of activity you are suitable for.
5, before the activity needs to think about whether the activity is appropriate.
6. Avoid any physical activity that involves rapid start-stop, twisting and impact on the surgical side of the elbow joint.
7. Do not use the upper extremity of the operated side to push any heavy objects.