Contents
One of the most complex mechanisms in the human body is the elbow joint. It combines the shoulder, that is, the upper limb from the shoulder to the elbow, and the forearm, that is, that part of the arm that is located below the elbow and above the hand.
Only one humerus functions inside the shoulder, and inside the forearm there are two such bones – the radius and ulna. This indicates that the elbow joint connects and ensures the activity of three bones at once with three simple joints – the humeroulnar, humeroradial and radioulnar. All of the above formations are combined into one capsule and form one elbow joint that is complex in structure and function.
Also, the complexity of the location of this bone formation in the body is the fact that the ulnar, radial and median nerves and a network of blood vessels pass next to it in the body.
Diseases in the study area
Diseases of the elbow joints can be triggered by trophic disorders, inflammatory processes, and injuries. However, due to the complex structure and location in the body, such areas are affected in a special way.
Even a minor injury to this zone without the occurrence of fractures, muscle tears or bleeding can cause ankylosis, contracture and other anomalies. In addition, most often the traditional treatment of the elbow joints gives a minimal effect, the most popular methods for solving problems with these areas in the body are surgical operations.
Among the frequent diseases that affect the area of the elbow joint, doctors distinguish epicondylitis of the external or internal epicondyles of the humerus, deforming arthrosis, bursitis, arthritis, exfoliating osteochondritis, pathological neuritis, compression of the ulnar nerves, valgus instability and numerous site injuries.
Due to the multifunctionality and complexity of the structure, in diseases of these areas, complications of the nearest vascular highways and nerves often occur. For problems with the elbow joints, each case of the patient is diagnosed in detail, subjecting him to a physical examination, radiography, ultrasound, and computed or magnetic resonance imaging, and only then they try to prescribe therapy.
Types of treatment
The main traditional non-invasive methods of treating the elbow joint classically include the appointment of analgesics, anti-inflammatory drugs, the use of physiotherapy exercises, physiotherapy procedures, they try to limit motor activity in the affected area, prescribe local glucocorticosteroid injections and other drugs.
These areas are also treated with the help of the latest orthopedic techniques, for example, in cases of arthrosis, gene therapy or shock wave therapy is used.
As noted above, in the elbow joint, conservative therapies often do not bring effectiveness, and surgical methods have to be resorted to. In this case, the patient needs such an operation that will preserve the full functionality of this area, and will consist in the reconstruction of the ligamentous apparatus, transplantation of cartilage tissue, articular arthroplasty.
Very often in such cases, minimally invasive arthroscopy is used, much less often – endoprosthesis replacement of the elbow joint. Endoprosthetics or total or partial replacement of the elbow joint is a complex operation, which is used less frequently in this area than in other areas of the skeleton, since the elbow joint carries much less physical stress than the same knee, for example.
To replace the elbow joint with an endoprosthesis, it is necessary to choose the right implant for this purpose:
- the endoprosthesis is checked for endurance of mechanical loads;
- the implant after surgery must provide unhindered movement in the installation area;
- for the prosthesis, resistant, but necessarily biologically compatible materials are selected.
Currently, only two types of endoprostheses are used in surgical clinics to replace elbow joints – hinged metal and hingeless silicone.
An absolute indication for endoprosthesis replacement of the described area is an irreversible deforming process in the elbow joint with concomitant multiple anatomical changes in the area of the adjacent bones and in the height of the joint space.
Contraindications to endoprosthesis replacement of the studied area are infectious processes in the human body, osteoporosis and other bone features, nerve damage in the elbow zone, atrophy of the muscle tissue of the elbow joint, and rheumatoid arthritis.
Endoprosthesis surgery
On the eve of arthroplasty, the specialist interrogates the patient in detail for the details of the occurrence of the pathology, directs him to additional diagnostic procedures and tests, and only after that evaluates the stage of damage to the elbow joint and the need to use one or another surgical technique. When choosing endoprosthesis replacement of the affected area, it will be necessary to approve the prosthesis model, the course of the surgical intervention and its method with a specialist.
During this operation, the patient is given general anesthesia, after which the doctor makes an incision in the area of uXNUMXbuXNUMXbthe joint that needs to be replaced. After incising the tissue, the specialist separates the muscles, and only after that the affected area is to be removed and replaced with an implant.
During arthroplasty, the surgeon performs resection of the bone tissues of the elbow joint, drilling channels into which the legs of the prosthesis will be placed, fixing the prosthesis with bone cement. After the implant is placed, the muscles are returned to their original position and the incision is sutured.
After arthroplasty, immediately, after only a day, the operated joint begins to be developed. This happens under the obligatory supervision of a physiotherapist. To relieve pain, the patient is prescribed analgesics and anti-inflammatory drugs. Subsequently, the patient begins to develop the joint on his own, according to the instructions of specialists from the clinic.
Risks and complications after arthroplasty
During any surgical intervention, there is a possibility of getting an infectious disease, which will not necessarily be provoked by the surgeon during the operation. It can also be caused by dental procedures after arthroplasty, and pathogens in the urinary system.
Therefore, it is worth using antibiotics for as long as 2 years after arthroplasty of the elbow joint on the eve of visiting dentists or any other doctors with invasive treatment methods.
Next to the installed implant, the process of osteolysis or destruction of the adjacent bone may begin due to the fact that the body has reacted to the direct contact of the metal and plastic components of the prosthesis, to the contact of the prosthesis and bone cement, to the contact of the prosthesis with the bone.
In rare cases, a fracture of the installed prosthesis is possible if the patient tries too actively to move the elbow joint after surgery or often experiences exorbitant physical exertion in this area.
In order to prevent fractures of the installed endoprostheses, it is necessary to follow all the prescriptions of doctors and not to get involved in physical activity associated with the functioning of the implant.
After endoprosthesis replacement of the elbow joints, it may be necessary to repeat such an operation in the future.
There are cases of allergic reactions to the components of prosthesis materials, system displacement due to improper installation, cementing, impacts.
Some patients develop cardiovascular anomalies that are provoked by bone cement and are expressed in the formation of blood clots, hypotension, and heart attacks.
Joint replacement can damage nearby nerves, blood vessels, and bone tissue.