Elbow Replacement

Types of Elbow Replacement

Mayo Clinic is a nationally recognized leader in the treatment of elbow joints affected by severe arthritis or injuries. The surgical options available include synovectomy, debridement, osteocapsular arthroplasty, interposition arthroplasty, open surgery for elbow joint replacement, and arthroscopic (minimally invasive) surgery. In addition, Mayo Clinic offers state-of-the-art rehabilitation to aid in recovery from elbow surgery.

Synovectomy
This treatment option, for patients with rheumatoid arthritis, involves a surgical procedure to remove inflamed synovial tissue around the elbow that is causing pain and swelling. At Mayo Clinic, this procedure is most often athroscopic surgery, a minimally invasive procedure involving small incisions at the elbow joint.

In some patients who have synovectomy, the synovium eventually grows back, perhaps resulting in a return of elbow pain after a few years. Medications can prevent the synovium from becoming inflamed again.

Debridement
In this procedure, for patients with osteoarthritis, the surgeon removes debris on and around the elbow joint. This debris includes bone spurs (osteophytes) and loose pieces of bone or cartilage. At Mayo, surgeons most often perform this procedure using an athroscope, which permits small incisions at the elbow joint.

Osteocapsular Arthroplasty
This is a complicated, newly developed procedure that involves synovectomy, along with a more thorough form of debridement that removes bone spurs, loose bone and loose cartilage, and a recontouring of bones that have become deformed or have deteriorated because of arthritis. Because this procedure requires significant expertise, Mayo Clinic is one of the few medical centers in the country where osteocapsular arthroplasty is performed.

Interposition Arthroplasty
This procedure is most often a treatment option for patients under age 60 who have severe arthritis. At Mayo Clinic, surgeons perform osteocapsular arthroplasty more frequently than interposition arthroplasty.

The procedure — resurfacing the joint — reduces joint pain by preventing the bones of the joint from rubbing together. A piece of skin (usually taken from the abdomen) or a piece of tendon (usually from the Achilles tendon) is used in the resurfacing. During surgery, the surgeon removes bone spurs or loose pieces of bone, then dislocates the elbow and stitches the skin or tendon in place between the bones that make up the elbow joint.

Interposition arthroplasty can be performed only as open surgery. Open surgery involves making a large incision at the elbow to remove the elbow joint and implant the artificial elbow joint.

Complications can include infection and paralysis of nerves in the elbow. Interposition arthroplasty can provide pain relief and improved function for up to 20 years. Patients may need an elbow joint replacement later.

Joint Replacement Surgery
Elbow replacement surgery involves removing the deteriorated bones of the elbow joint and replacing them with a hinged, metal prosthesis fitted to the size of the patient. Some patients may develop problems, such as an infection from the surgery or loosening of the prosthetic joint.

Increasingly, Mayo orthopedic surgeons are performing arthroscopic (minimally invasive) surgery, which involves the use of smaller surgical incisions than traditional total joint replacement. Most patients experience shorter hospital stays and less blood loss from minimally invasive surgery.