I'm thinking about maybe getting an elbow replacement. I read somewhere that you have to be willing to follow some restrictions for the rest of your life. What are these?
Total elbow arthroplasty (replacement) can be helpful for the older adult (65 years or older) who has severe pain and loss of elbow motion and function. The cause of the elbow problems may be from rheumatoid arthritis, osteoarthritis, or years later after a traumatic injury.
Conservative care is always recommended before surgery. If after at least six months of trying activity modifications, medications, and hand therapy, there has not been any (or enough) improvement, then surgery may be considered. It is true that there are some activity restrictions -- primarily you must not engage in any activities that require lifting more than 10 pounds.
That may seem like it's no problem. But if you have grandchildren, it means not trying to lift them up no matter what the circumstances. You'll have to be careful when grocery shopping, gardening, or other activities that involve placing a load on the elbow.
Today's improved elbow implants do a better job of reproducing normal elbow motion than earlier designs. The newer prostheses allow for side-to-side and rotational motions needed for full elbow motion. Various implant systems are available now (e.g., constrained, unconstrained, convertible, fixed).
Each new generation of implant designs try to improve elbow stability while still allowing mobility at the same time preserving bone and soft tissue structures. Patients who have arthritis compounded by fractures and/or loss of bone mineral density may need one of these newer implants. Older adults seem to do better with elbow implants than younger patients. They have far fewer problems and are much less likely to need a second (or third) surgery.
Companies designing and making elbow implants continue to look for better materials that won't wear loosen, or break. Preventing mechanical failure of the implant will improve long-term results for patients with various kinds of elbow problems. There is still a need to find an implant that will hold up with active use for younger patients who have debilitating elbow arthritis.
Zinon T. Kokkalis, MD, et al. Elbow Arthritis: Current Concepts. In The Journal of Hand Surgery. April 2009. Vol. 34A. No. 4. Pp. 761-768.
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