What is Interposition Arthroplasty of the Elbow?
Interposition arthroplasty is a surgical method that can be used for the treatment of arthritis in the elbow joint. In this procedure, soft tissue is placed between the damaged portions of the elbow joint preventing the bones from rubbing against each other. Over the course of time, this soft tissue forms a false joint.
The elbow is considered the most important joint in the arm. It allows you to bend your arm as well as rotate your wrists. The structure and working of the elbow joint are quite similar to an ordinary hinge joint. The elbow has two portions, the upper portion formed by the upper arm bone called the humerus, and the lower portion formed by the two bones in the forearm, the radius, and the ulna. Since the elbow connects three bones, it has three junctions, namely: the proximal radioulnar joint between the radius and ulna, the ulnohumeral joint between the ulna and humerus, and the radiohumeral joint between the humerus and the radius. Degenerative disease or trauma to these joints can affect the proper movement of the arm.
What is Elbow Arthritis?
One of the most common diseases affecting the elbow joint is arthritis, a condition in which there is the loss of cartilage that normally covers the bones in the joints. This causes the underlying bones to rub against each other during movement leading to pain and loss of mobility.
Advantage of Interposition Arthroplasty
Interposition arthroplasty is recommended as it separates the damaged joint surfaces preventing further damage and pain while retaining mobility of the joint.
Procedure of Interposition Arthroplasty
- The surgery generally takes up to one and a half hours and may be performed under local or general anesthesia.
- After the administration of anesthesia, your surgeon will make an incision and operate through the back of the elbow to avoid damaging important nerves and vessels.
- Your surgeon carefully moves the ligaments, tendons, and the ulnar nerve out of the way and removes any scar tissue and bone spurs from the joint.
- The ends of the affected elbow joint are then shaped to receive new tissue that will be placed between the joint.
- Once space is made, your surgeon uses soft tissue obtained from another part of the body such as fascia tissue from the thigh which is folded and sewn to the humerus. This forms a layer of separation between the joint surfaces of the elbow.
- The soft tissues over the elbow joint are then stitched back in place and metal pins are placed through the skin into the humerus and ulna. The surfaces of the elbow joint are held slightly apart using a hinged elbow brace that is connected to the metal pins.
Postoperative Care for interposition Arthroplasty
The elbow brace is used for almost 4-6 weeks post-surgery to facilitate the natural healing process. Physical therapy sessions including general motion exercises, active elbow movements, and passive stretching will be recommended by your doctor to help deal with the swelling and pain and regain strength and movement of the elbow. Massage and heat treatments may also be suggested to ease the pain and encourage the healing process.
Complication of Interposition Arthroplasty
As with all surgical procedures, complications may occur. Some of the most common complications include:
- Nerve or blood vessel damage