24362 Arthroplasty, elbow; with implant and fascia lata ligament reconstruction

Name of the Procedure:

Arthroplasty, elbow; with implant and fascia lata ligament reconstruction

Summary

Elbow arthroplasty with implant and fascia lata ligament reconstruction is a surgical procedure to restore the function and stability of a damaged elbow joint. This is achieved by placing an artificial implant and reconstructing the ligaments using grafts, typically from the fascia lata, a strip of tissue from the thigh.

Purpose

This procedure addresses severe elbow joint damage due to arthritis, trauma, or degenerative diseases. The primary goals are to relieve pain, improve range of motion, and restore stability and function to the elbow joint.

Indications

• Persistent and severe elbow pain
• Significant loss of elbow function and movement
• Elbow joint deformity
• Chronic instability of the elbow
• Failure of conservative treatments like medication and physical therapy

Preparation

• Patients may be instructed to fast for 8-12 hours before surgery.
• Pre-operative assessments, including blood tests, imaging studies (X-rays, MRI), and possibly an evaluation by an anesthesiologist.
• Adjustment or discontinuation of certain medications, particularly blood thinners.

Procedure Description

1. Anesthesia is administered, typically general anesthesia or a regional block.
2. An incision is made over the elbow joint.
3. The damaged portions of the elbow are removed.
4. The implant (prosthesis) is placed into the joint space.
5. A graft is taken from the fascia lata tissue in the thigh.
6. The harvested fascia lata is used to reconstruct the ligaments, providing stability to the joint.
7. The incision is closed with sutures and a sterile bandage is applied.

Duration

Approximately 2 to 3 hours.

Setting

Performed in a hospital or surgical center operating room.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Infection
• Blood clots
• Implant loosening or failure
• Nerve or blood vessel damage
• Persistent pain or stiffness
• Allergic reactions to anesthesia

Benefits

• Significant reduction in pain
• Improved elbow function and range of motion
• Enhanced joint stability
• Higher quality of life

Recovery

• Patients may stay in the hospital for a few days.
• Pain management with prescribed medications.
• Physical therapy will be required to regain motion and strength.
• Recovery may take several months, with restrictions on lifting and certain activities.

Alternatives

• Non-surgical treatments: medication, physical therapy, corticosteroid injections.
• Arthroscopic elbow procedures for less severe cases.
• Pros: Non-invasive, less recovery time.
• Cons: May not provide long-term relief or sufficient improvement in severe cases.

Patient Experience

• Patients may feel discomfort and pain managed by medications.
• Swelling and bruising around the elbow and thigh (donor site).
• Gradual improvement in function with ongoing physical therapy and rehabilitation.
• Long-term prognosis is generally positive, with improved joint function and pain reduction.