Our Summary

This research paper is a review of the long-term results of total elbow arthroplasty (TEA), a surgical procedure where the damaged parts of the elbow are replaced with artificial components. Two reviewers looked at various studies on this topic, and they only included those that had tracked patient outcomes for at least 10 years after the surgery.

They found 23 studies involving 1429 elbow replacements in patients who were mostly women and had an average age of about 65 years. They followed up with these patients for an average of over 11 years. The researchers used three different scoring systems to measure the patients’ elbow performance and disabilities related to their arms, shoulders, and hands. Most patients reported having no pain, and the average scores indicated good elbow function and low disability.

The review also looked at complications arising from the surgery. About 13% of patients had aseptic loosening (where the artificial elbow becomes loose without any signs of infection), 3.3% had infections, 4.2% had dislocation of the implant, and 2.1% had nerve injury. About 16.3% of patients faced complications and about 14.6% needed revision surgery to correct problems.

The study concludes that TEA provides satisfactory outcomes for patients in the long term, with complication and revision rates not increasing significantly compared to the short and medium term. This makes TEA a reliable option for patients needing elbow replacement.

FAQs

  1. What are the long-term functional outcomes after total elbow arthroplasty (TEA)?
  2. What are the complication and revision rates following TEA at a minimum of 10 years’ follow-up?
  3. What was the average age of patients who underwent TEA in the studies reviewed?

Doctor’s Tip

One helpful tip a doctor might tell a patient about elbow surgery is to follow post-operative rehabilitation exercises and physical therapy diligently to ensure optimal recovery and range of motion. It is important to communicate any discomfort or concerns with your healthcare provider to address any potential issues promptly. Additionally, maintaining a healthy lifestyle with proper nutrition and exercise can aid in the healing process and overall success of the surgery.

Suitable For

Patients who are typically recommended for elbow surgery, specifically total elbow arthroplasty (TEA), include those with rheumatoid arthritis (RA) or other conditions that cause severe elbow pain, stiffness, and loss of function. These patients may have failed conservative treatments such as medication, physical therapy, and corticosteroid injections, and may have significant joint damage that affects their daily activities and quality of life. Additionally, patients with severe elbow fractures, instability, or osteoarthritis may also be candidates for elbow surgery. It is important for patients considering elbow surgery to discuss their individual case with a healthcare provider to determine the most appropriate treatment option.

Timeline

Before elbow surgery:

  1. Patient experiences pain, stiffness, and limited range of motion in the elbow joint.
  2. Patient undergoes consultations and evaluations with orthopedic surgeons to determine the need for surgery.
  3. Pre-operative tests and imaging studies are conducted to assess the condition of the elbow joint.
  4. Patient receives pre-operative instructions regarding diet, medications, and physical therapy.
  5. Surgery date is scheduled and patient prepares for the procedure.

After elbow surgery:

  1. Patient undergoes the surgical procedure, which may involve total elbow arthroplasty (TEA) in cases of severe joint damage.
  2. Post-operatively, patient is monitored in the hospital for pain management and to prevent complications such as infection or implant dislocation.
  3. Patient undergoes physical therapy and rehabilitation to regain strength, range of motion, and functionality in the elbow joint.
  4. Follow-up appointments with the surgeon are scheduled to monitor healing and address any concerns or complications.
  5. Long-term follow-up assessments are conducted to evaluate the functional outcomes, dislocation rates, and revision rates of the TEA procedure, usually at a minimum of 10 years post-surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with elbow surgery?
  2. What is the expected recovery time and rehabilitation process after elbow surgery?
  3. How long do the results of elbow surgery typically last?
  4. What are the alternative treatment options to elbow surgery?
  5. What type of anesthesia will be used during the surgery?
  6. How experienced is the surgeon in performing elbow surgeries?
  7. What is the success rate of elbow surgery in patients with similar conditions?
  8. Will I need physical therapy after the surgery? If so, for how long?
  9. Are there any specific restrictions or limitations I should be aware of after elbow surgery?
  10. How often will follow-up appointments be needed after the surgery?

Reference

Authors: Davey MS, Hurley ET, Gaafar M, Molony D, Mullett H, Pauzenberger L. Journal: J Shoulder Elbow Surg. 2021 Jun;30(6):1423-1430. doi: 10.1016/j.jse.2020.11.014. Epub 2021 Jan 5. PMID: 33418089