Arthroplasty, radial head
CPT4 code
Name of the Procedure:
- Arthroplasty, Radial Head
- Commonly known as radial head replacement surgery
Summary
Radial head arthroplasty is a surgical procedure to replace the radial head, which is the top part of one of the forearm bones, with an artificial implant. This surgery is usually performed to relieve pain and restore function to an injured or diseased elbow joint.
Purpose
- Medical Conditions Addressed: Severe fractures, arthritis, or other degenerative conditions of the radial head.
- Goals: To reduce pain, improve elbow function and range of motion, and prevent future joint damage.
Indications
- Severe pain and swelling in the elbow.
- Limited range of motion or mechanical block.
- Non-responsive to conservative treatments such as medication and physical therapy.
- Complex or irreparable fractures of the radial head.
- Elbow stability needs reconstruction after trauma.
Preparation
- Patients may need to fast for 8-12 hours before surgery.
- Adjustments to medications, especially blood thinners, might be required.
- Preoperative diagnostic tests include X-rays, MRI, or CT scans to assess the extent of injury.
Procedure Description
- Anesthesia: The patient is given general anesthesia or a regional nerve block.
- Incision: A surgical incision is made over the lateral (outer) aspect of the elbow.
- Exposure: The radial head is exposed by carefully moving muscles and tendons aside.
- Removal: The damaged or fractured radial head is removed.
- Implantation: An appropriately sized artificial radial head is selected and implanted.
- Closure: The surgical site is closed with sutures or staples, and a sterile dressing is applied.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
Radial head arthroplasty is usually performed in a hospital operating room or a specialized surgical center.
Personnel
- Orthopedic Surgeon
- Surgical Assistants
- Scrub Nurse
- Anesthesiologist
Risks and Complications
- Common Risks: Infection, bleeding, swelling, and pain at the surgical site.
- Rare Risks: Nerve or blood vessel damage, implant dislocation or failure, stiffness or decreased range of motion, and allergic reaction to the implant material.
- Management: Most complications can be managed with medications, physical therapy, or additional surgical interventions.
Benefits
- Significant reduction in pain.
- Improved elbow function and range of motion.
- Enhanced quality of life.
- Benefits may be realized immediately after recovery from anesthesia, with continued improvement over the following weeks and months.
Recovery
- Post-Procedure: Initial immobilization of the elbow with a splint or brace.
- Instructions: Ice application, pain management medications, and wound care.
- Recovery Time: Typically 6-12 weeks for full recovery, with physical or occupational therapy recommended.
- Restrictions: Avoid heavy lifting and strenuous activities during the initial recovery phase. Follow-up appointments for progress monitoring.
Alternatives
- Non-surgical options like physical therapy, medication, and injections.
- Partial removal of the damaged radial head (radial head excision).
- Conservative management and lifestyle changes.
- Pros and Cons: Non-surgical methods may offer temporary relief but do not address severe structural damage. Radial head arthroplasty offers the best chance for restoring function in severe cases.
Patient Experience
Patients will not feel pain during the procedure due to anesthesia. Post-operatively, there may be discomfort or mild pain managed with medications. Temporary restrictions on the use of the affected arm and adherence to physical therapy are crucial for a successful recovery and regaining strength and mobility.
This template provides comprehensive and useful information for patients and helps guide their understanding and expectations regarding radial head arthroplasty.