Arthrodesis, elbow joint; with autogenous graft (includes obtaining graft)
CPT4 code
Name of the Procedure:
Arthrodesis, elbow joint; with autogenous graft (includes obtaining graft) Common name(s): Elbow Joint Fusion, Elbow Arthrodesis
Summary
Arthrodesis of the elbow joint is a surgical procedure to fuse the bones of the elbow, eliminating joint movement to provide stability and alleviate pain. This is achieved using a graft taken from the patient's own body (autogenous graft).
Purpose
The procedure addresses severe elbow joint pain or instability, often due to arthritis, injury, or deformity. The goal is to stabilize the joint, relieve pain, and improve the patient's quality of life, even though it results in loss of joint flexibility.
Indications
- Severe, chronic elbow pain unresponsive to conservative treatments
- Significant joint instability or deformity
- Advanced arthritis or degenerative joint disease
- Failed previous elbow surgeries
- Traumatic elbow injuries with severe bone loss
Preparation
- Patients may need to fast for several hours before the surgery.
- Adjustments to medications, especially blood thinners, as directed by the healthcare provider.
- Preoperative tests may include blood work, imaging studies (X-rays, CT scans), and a physical examination.
Procedure Description
- Anesthesia: The patient is given general anesthesia or regional anesthesia to numb the area.
- Incision: A surgical cut is made over the elbow joint.
- Bone Preparation: The damaged cartilage is removed, and the joint surfaces are prepared.
- Graft Harvesting: Bone graft is taken from another part of the patient's body, commonly the iliac crest (hip bone).
- Grafting and Fixation: The graft is placed between the bones of the elbow, and the bones are fixed together using screws, plates, or rods to ensure stability.
- Closure: The incision is closed with sutures or staples, and a bandage is applied.
Duration
The procedure typically takes 2 to 3 hours, varying with complexities.
Setting
It is performed in a hospital's surgical suite or an outpatient surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Surgical technologists
Risks and Complications
- Infection
- Nerve damage
- Blood clots
- Non-union, where the bones do not fuse properly
- Donor site pain or complications
- Loss of elbow function
- Anesthesia-related risks
Benefits
- Significant pain relief
- Increased joint stability
- Improved daily function without the hindrance of severe pain
Recovery
- Postoperative care includes pain management, antibiotics if needed, and physical therapy.
- The arm may be in a splint or cast for several weeks.
- The typical recovery time ranges from 3 to 6 months.
- Avoid heavy lifting and strenuous activities during recovery.
- Follow-up appointments for X-rays and progress evaluation.
Alternatives
- Medication management (pain relievers, anti-inflammatories)
- Corticosteroid injections
- Physical therapy
- Joint replacement (arthroplasty)
- The choice between arthrodesis and alternatives depends on factors such as patient age, activity level, and specific condition severity.
Patient Experience
- Some discomfort and pain post-surgery, managed with medications.
- Swelling and limited mobility initially.
- Gradual improvement in stability and reduction in pain.
- Long-term loss of elbow flexibility, but better overall arm function.