Elbow replacement (prosthesis)

Prosthetic replacement of the elbow joint:   

Elbow replacement surgery removes damaged areas of the elbow joint and replaces them with parts made of metal and plastic (implants). This surgery is also called elbow arthroplasty.

Three bones meet in the elbow. The upper arm bone (humerus) connects like a loose hinge to the larger of the two forearm bones (ulna). The two forearm bones (radius and ulna) work together to provide rotation.

Traditionally, elbow replacement surgery has had a higher rate of complications than surgeries to replace hip or knee joints. But recent advances in surgical technique and implant design have improved the success rate of elbow replacements.

Causes

Several conditions can cause elbow pain and disability, and lead patients and their doctors to consider elbow joint replacement surgery.

Rheumatoid Arthritis

Rheumatoid arthritis is the most common form of a group of disorders termed "inflammatory arthritis." This is a disease in which the synovial membrane that surrounds the joint becomes inflamed and thickened. This chronic inflammation can damage the cartilage and eventually cause cartilage loss, pain, and stiffness.

Osteoarthritis (Degenerative Joint Disease)

Osteoarthritis is an age-related, wear and tear type of arthritis. It usually occurs in people age 50 and older but may occur in younger people, too. The cartilage that cushions the bones of the elbow softens and wears away. The bones then rub against one another. Over time, the elbow joint becomes stiff and painful.

Posttraumatic Arthritis

This type of arthritis can follow a serious elbow injury. Fractures of the bones that make up the elbow, or tears of the surrounding tendons and ligaments may cause damage to the articular cartilage over time. This causes pain and limits elbow function.

Severe Fractures

A severe fracture of one or more bones that make up the elbow is another common reason people have elbow replacements. If the elbow is shattered, it may be very difficult for a surgeon to put the pieces of bone back in place. In addition, the blood supply to the bone pieces can be interrupted. In this type of case, a surgeon may recommend an elbow replacement. 

In addition, some fractures do not heal well and may require an elbow replacement to address continuing problems.

Older patients with osteoporosis (fragile bone) are most at risk for severe elbow fractures.

Instability

Instability occurs when the ligaments that hold the elbow joint together are damaged and do not work well. The elbow is prone to dislocation.

Chronic instability is most often caused by an injury.

Elbow replacement procedures

In some cases, you may need a replacement of just one portion of the joint. For example, if only the head of one of your forearm bones (radius) is damaged, it can be replaced with an artificial head.

If the entire joint needs to be replaced, the ends of the bones that come together in the elbow will be reshaped. Bones are hard tubes that contain a soft center. The long, slender ends of the artificial parts are inserted into the softer central part of the bones.

If the surrounding ligaments aren't strong enough to hold the joint together by themselves, the surgeon may use a linking cap so that the artificial implants can't come apart

With intermediate degrees of residual weakness, pain or limitation of motion rate by analogy to diagnostic codes 5205 through 5208.