Our Summary

This research paper looks at how often, and with what results, surgeons at a particular hospital had to modify artificial elbow joint implants (Total Elbow Arthroplasty, or TEA) during surgery. The team looked at surgeries that took place over about 27 years, and found that 13% of the time, the implant had to be adjusted in some way to fit the patient. This was more common when the surgery was to replace an old implant, rather than putting in a new one for the first time.

The changes to the implants included shortening, bending, notching, or tapering the part of the implant that goes into the bone. Sometimes, two or more of these changes were needed.

The study also found that about half the surgeries had complications, but most of these were not related to the changes made to the implant. Only 15% of the complications were possibly or probably related to the changes. No complications were definitely related to the changes, and no implants broke or stopped working because of the changes.

The researchers also asked surgeons in other hospitals around the world about this issue, and found that about two-fifths of them also had to modify elbow joint implants during surgery. The researchers concluded that while modifying implants might sometimes be necessary, surgeons should do so thoughtfully and carefully, as there could be a 15-30% chance of related complications.

FAQs

  1. How often did surgeons have to modify artificial elbow joint implants during surgery according to the research?
  2. What kind of modifications were made to the elbow joint implants during surgery?
  3. What was the percentage of complications related to the modifications made to the elbow joint implants?

Doctor’s Tip

A helpful tip a doctor might tell a patient about elbow surgery is to follow post-operative instructions carefully, including completing physical therapy as recommended. This will help ensure proper healing and reduce the risk of complications. Additionally, it’s important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended elbow surgery include those with severe arthritis, fractures, ligament injuries, and other conditions that cause pain, stiffness, and limited range of motion in the elbow joint. Additionally, patients who have failed conservative treatments such as physical therapy, medications, and injections may also be candidates for elbow surgery. It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if surgery is the best option for their specific condition.

Timeline

Before elbow surgery:

  • Patient experiences pain, stiffness, and limited range of motion in the elbow
  • Patient consults with a doctor and undergoes physical exams, imaging tests, and possibly other diagnostic tests to determine the need for surgery
  • Patient discusses surgical options, risks, and benefits with the surgeon
  • Patient undergoes pre-operative preparations, such as blood tests, medication adjustments, and lifestyle modifications

After elbow surgery:

  • Patient undergoes the surgery, which may involve replacing the damaged elbow joint with an artificial implant
  • Surgeon may need to make adjustments to the implant during the surgery to ensure proper fit and function
  • Patient is monitored in the recovery room and may stay in the hospital for a few days for observation and pain management
  • Patient undergoes physical therapy and rehabilitation to regain strength, mobility, and function in the elbow
  • Patient follows post-operative instructions, such as taking medications, attending follow-up appointments, and avoiding certain activities
  • Patient gradually resumes normal activities and may experience improvements in pain, range of motion, and overall function in the elbow.

What to Ask Your Doctor

  1. What specific type of elbow surgery will I be undergoing?
  2. Why is surgery necessary for my condition?
  3. What are the risks and benefits of the surgery?
  4. How often do you have to modify artificial elbow joint implants during surgery?
  5. What types of modifications may need to be made to the implant during my surgery?
  6. How will these modifications affect the long-term success of the implant?
  7. What is the likelihood of complications related to the modifications made to the implant?
  8. Are there any alternative treatment options to surgery?
  9. What is the expected recovery time and rehabilitation process after the surgery?
  10. How many of these surgeries have you performed, and what is your success rate?
  11. What can I do to prepare for the surgery and improve my chances of a successful outcome?
  12. Are there any restrictions or limitations I should be aware of after the surgery?

Reference

Authors: Walch A, Jensen AR, Nishikawa H, Morrey ME, Sanchez-Sotelo J, O’Driscoll SW. Journal: J Shoulder Elbow Surg. 2023 Jul;32(7):1494-1504. doi: 10.1016/j.jse.2023.02.124. Epub 2023 Mar 12. PMID: 36918118