Name of the Procedure:

Arthroplasty, radial head; with implant

Common name(s): Radial Head Arthroplasty, Radial Head Replacement

Summary

Radial head arthroplasty is a surgical procedure where the damaged or fractured radial head (the top part of the radius bone in the elbow) is removed and replaced with an artificial implant.

Purpose

The procedure is intended to address severe fractures, arthritis, or other damage to the radial head that impairs elbow function and causes pain. The goal is to restore function, reduce pain, and improve the range of motion in the elbow.

Indications

• Complex or comminuted fractures of the radial head that cannot be repaired.
• Chronic elbow instability due to radial head damage.
• Severe arthritis of the elbow that has not responded to non-surgical treatment.
• Failure of previous surgeries on the radial head.

Preparation

• Fasting for at least 8 hours before the procedure.
• Stopping certain medications, such as blood thinners, as instructed by the surgeon.
• Preoperative imaging studies like X-rays or CT scans to assess the extent of damage.
• Preoperative physical examination and blood tests.

Procedure Description

1. Administration of general anesthesia or regional anesthesia (nerve block).
2. An incision is made over the lateral aspect of the elbow to expose the radial head.
3. The damaged radial head is carefully removed.
4. The canal of the proximal radius is prepared to receive the implant.
5. The prosthetic radial head is inserted and secured in place.
6. The joint is checked for stability and range of motion.
7. The incision is closed with sutures or staples, and a bandage 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
• Anesthesiologist
• Surgical nurses
• Scrub technician

Risks and Complications

• Infection at the surgical site
• Nerve or blood vessel injury
• Implant loosening or failure
• Stiffness or limited range of motion
• Allergic reaction to the implant material
• Need for additional surgeries

Benefits

• Improved elbow stability and function
• Pain relief
• Enhanced range of motion
• Likelihood of returning to daily activities and sports

Recovery

• Initial immobilization with a splint or sling.
• Pain management with prescribed medications.
• Gradual initiation of physical therapy to restore motion and strength.
• Avoid heavy lifting or strenuous activities for several weeks.
• Follow-up appointments to monitor healing and implant position.
• Full recovery may take several months.

Alternatives

• Nonsurgical management: Physical therapy, medications, and bracing.
• Radial head excision: Removal of the damaged head without replacement.
• Open reduction and internal fixation (ORIF) for certain fracture types.
• Pros of alternatives: Less invasive options may have shorter recovery times.
• Cons of alternatives: May not restore full function and stability like arthroplasty.

Patient Experience

During the procedure, the patient will be under anesthesia and won’t feel pain. Postoperatively, there may be discomfort and swelling, which can be managed with pain medication. Physical therapy will be essential for regaining strength and mobility, and the healthcare team will guide the patient through each step of recovery.