Name of the Procedure:

Removal of prosthesis, includes debridement and synovectomy when performed; humeral and ulnar components

Summary

In this surgical procedure, a doctor removes previously implanted prosthetic components from the upper arm (humerus) and the lower arm (ulna). The procedure may also include cleaning out infected or dead tissue (debridement) and removing the inflamed or damaged joint lining (synovectomy).

Purpose

The procedure addresses issues such as infection, prosthesis failure, or complications from a previous surgery. The goal is to alleviate pain, restore function, and prevent further complications.

Indications

• Infection at the prosthetic site
• Mechanical failure or loosening of the prosthesis
• Severe pain or dysfunction of the elbow joint
• Poor outcomes from previous elbow surgery
• Diagnosis of inflammatory conditions affecting the joint, e.g., rheumatoid arthritis

Preparation

• Patients may need to fast for a specific duration before the procedure.
• Adjustments to medications, like blood thinners, are often required.
• Pre-operative diagnostics may include blood tests, imaging studies (e.g., X-rays or MRI), and infection tests.

Procedure Description

1. The patient is typically given general anesthesia.
2. An incision is made at the elbow to access the prosthetic components.
3. The surgeon carefully removes the humeral and ulnar prosthetic parts.
4. Debridement is performed to clean out any infected or dead tissue.
5. A synovectomy is done to remove inflamed or damaged joint lining, if necessary.
6. The surgical site is closed with sutures or staples.
7. A sterile dressing is applied to the incision.

Duration

The procedure typically takes between 2 to 3 hours, depending on complexity.

Setting

The procedure is usually performed in a hospital surgical theater or an outpatient surgery center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses and technicians

Risks and Complications

• Infection
• Excessive bleeding
• Nerve or blood vessel damage
• Anesthesia reactions
• Joint stiffness or decreased range of motion
• Recurrence of the problem

Benefits

• Relief from pain and discomfort
• Improved joint function and mobility
• Reduced risk of further infections or complications
• Potentially improved quality of life

Recovery

• Post-operation, patients may need to stay in the hospital for a few days.
• Physical therapy is often required to regain movement and strength.
• Patients are advised to avoid strenuous activities for several weeks.
• Follow-up appointments are necessary to monitor healing.

Alternatives

• Revision surgery to replace the prosthetic components
• Non-surgical treatments such as medications, physical therapy, or joint injections
• Pros and cons: Non-surgical treatments may offer less immediate relief and effectiveness; revision surgery carries similar risks but higher chances for prolonged functionality.

Patient Experience

During the procedure, the patient will be under anesthesia and won’t feel pain. Post-operatively, there will be some pain and discomfort managed with medications. Patients may experience swelling, bruising, and limited mobility temporarily, but these should improve with time and therapy.