Many conditions are amenable to keyhole elbow surgery which is generally very successful.

The surgery is usually performed under general anaesthetic (asleep), sometimes with an additional local anaesthetic ‘nerve block’, which is performed by the anaesthetist.

Several small (0.5cm) incisions are made around the elbow. The number and location depend on the type of surgery that is being performed.

A camera and other instruments are inserted through the incisions into the front and back of the joint. Visualisation is improved by running fluid into the shoulder.

What is Elbow Hemiarthroplasty?

The elbow is a complicated hinge joint. It is formed by the bottom of the arm bone (the humerus) which articulates with the forearm bones (the radius and the ulna)

Elbow hemiarthroplasty is a rarely undertaken treatment option for severe elbow fractures where the end of the humerus cannot be repaired

How is this surgery performed?

The end of the humerus is removed and replaced by metal. Torn ligaments are then repaired.

The metal component of the humerus then articulates with the cartilage of the radius and ulna.

What is Elbow Replacement?

The elbow is a complicated hinge joint. It is formed by the bottom of the arm bone (the humerus) which articulates with the forearm bones (the radius and the ulna)

Elbow replacement is a treatment option for elbow arthritis where the patient remains symptomatic despite appropriate non-operative treatment and minimally invasive surgery is not appropriate or has not worked. It is also sometimes used in severe fractures of the end of the humerus that cannot be repaired.

How is this surgery performed?

The worn out surfaces of the humerus and the ulna are replaced by metal and plastic (polyethylene). The surface of the radius is either removed or replaced.

What is Osteoarthritis?

Osteoarthritis (OA) is degenerative joint disease. The ends of bones are covered with cartilage which forms the normal smooth gliding surface responsible for pain free movement. In OA there is a failure of the normal repair mechanisms and cartilage is lost. As a result, the gliding surface is no longer smooth. At the extreme, cartilage is lost completely (bone on bone). The body responds to this by producing extra bone around the margins of the joint (osteophytes). Sometimes these break off to form loose bodies that may move around the joint.

What are the symptoms of Osteoarthritis?

In the elbow the typical symptoms of arthritis are stiffness and pain at the extremes of motion (impingement) due to the osteophytes. Loose bodies can jam in the joint and cause sudden severe pain and inability to move (locking).

Surgery for Osteoarthritis

Surgery is only undertaken if other treatment options have failed.

Unlike other joints, elbow arthroplasty (replacement) is not commonly performed for osteoarthritis. Impingement pain and stiffness can be reliably improved by cutting tightened soft tissues and removing osteophytes and loose bodies.

Depending on the size and location of osteophytes and loose bodies and the severity of the stiffness this surgery may be done through arthroscopic (keyhole) surgery or through a small open incision either at the back of the elbow or the side.

Types of Trauma to the Elbow

The elbow is frequently injured in falls, sports and motor vehicle accidents.

The elbow is a complicated hinge joint. It is formed by the bottom of the arm bone (the humerus) which articulates with the forearm bones (the radius and the ulna) through the radial head and the olecranon.

The most commonly injured areas around the elbow are the radial head, olecranon and the end of the humerus (distal humerus).

Surgery for Trauma of the Elbow

In each of these cases surgery may be needed if the fracture is likely to not heal (nonunion) or to heal in a position that will cause pain, stiffness or dysfunction (malunion).

If surgery is needed, then the fracture can usually be fixed with screws and plates. Occasionally if the fracture is not repairable then a replacement (arthroplasty) is needed.