Our Summary

This research paper delves into the rate and causes of amputation following Total Elbow Arthroplasty (TEA), a surgical procedure that replaces the elbow joint with an artificial one, conducted at a particular medical institution.

From 1973 - 2018, a total of 1906 TEAs were carried out at this institution. Out of these, seven cases (0.36%) ended up needing an upper extremity amputation. The reasons for these amputations were primarily due to deep infections that couldn’t be controlled (86% of cases) and recurrence of a tumor (14% of cases).

The study finds that the rate of amputation after TEA is quite low, but the outcomes for patients who do need an amputation are not very promising. Most patients did not survive very long after their amputations, and only one patient was able to be fitted with a prosthetic.

In simple terms, getting a TEA has a low chance of leading to amputation, but if it does happen, the outcomes aren’t great. Most of the time, the need for amputation is due to infections that can’t be controlled or a returning tumor.

FAQs

  1. What is the rate of amputation following Total Elbow Arthroplasty (TEA) according to the research paper?
  2. What are the primary reasons for amputation following TEA?
  3. What are the outcomes for patients who need an amputation after TEA?

Doctor’s Tip

One helpful tip a doctor might tell a patient about elbow surgery is to closely follow post-operative care instructions to reduce the risk of infection. This can include keeping the surgical site clean, taking prescribed antibiotics as directed, and attending follow-up appointments to monitor healing progress. By taking these precautions, patients can help prevent complications that may lead to the need for amputation.

Suitable For

Therefore, patients who are recommended elbow surgery, such as Total Elbow Arthroplasty, are typically those who have severe arthritis or injuries to their elbow joint that significantly impact their quality of life and function. These patients may experience chronic pain, limited range of motion, and difficulty performing daily activities. In some cases, patients may also have conditions such as rheumatoid arthritis or post-traumatic arthritis that necessitate surgical intervention to improve their elbow function.

It is important for patients considering elbow surgery to discuss the potential risks and benefits with their healthcare provider, as well as to understand the post-operative rehabilitation process and expected outcomes. While the risk of amputation following elbow surgery is low, it is crucial for patients to be aware of the potential complications and to follow their healthcare provider’s recommendations for post-operative care to minimize the risk of adverse outcomes.

Timeline

Before elbow surgery:

  1. Patient experiences pain, limited range of motion, and possibly swelling in the elbow joint.
  2. Consultation with a healthcare provider to determine the need for surgery and discuss the procedure.
  3. Pre-operative assessments and tests are conducted to ensure the patient is healthy enough for surgery.
  4. Pre-surgical preparations such as fasting, medication adjustments, and instructions on post-operative care are given to the patient.

After elbow surgery:

  1. Patient wakes up in the recovery room and may experience pain, swelling, and limited mobility in the operated elbow.
  2. Physical therapy and rehabilitation exercises are initiated to help regain strength and mobility in the elbow joint.
  3. Follow-up appointments with the surgeon to monitor the healing process and address any concerns or complications.
  4. Gradual return to normal activities and work, with restrictions on certain movements or heavy lifting.
  5. Long-term follow-up to monitor the success of the surgery and address any potential complications or need for further interventions.

What to Ask Your Doctor

Some questions a patient should ask their doctor about elbow surgery include:

  1. What are the potential risks and complications associated with total elbow arthroplasty?
  2. What is the likelihood of needing an amputation following elbow surgery?
  3. What steps can be taken to reduce the risk of infection after surgery?
  4. How will the doctor monitor for any signs of infection or other complications post-surgery?
  5. What is the typical recovery time and rehabilitation process after total elbow arthroplasty?
  6. Are there any alternative treatments or procedures that could be considered instead of surgery?
  7. How often will follow-up appointments be needed to monitor the success of the surgery?
  8. What are the long-term outcomes and potential limitations following elbow surgery?
  9. How experienced is the surgeon in performing total elbow arthroplasty procedures?
  10. Are there any specific lifestyle changes or precautions that should be taken after surgery to prevent complications?

Reference

Authors: Claxton MR, Shirley MB, Nauert RF, Morrey ME, Sanchez-Sotelo J, Houdek MT. Journal: Int Orthop. 2021 May;45(5):1281-1286. doi: 10.1007/s00264-020-04906-1. Epub 2021 Jan 15. PMID: 33447873