Total Elbow Arthroplasty

Abstract

The value of total elbow arthroplasty is best demonstrated in patients with rheumatoid arthritis. Dr. Morrey performs an elbow joint replacement in a 51-year old woman with a very severe form of rheumatoid arthritis involving all of her joints. At the elbow, the destruction is so extensive as to closely resemble what is termed mutilans—that is, complete alteration of the arm architecture. This particular patient's presentation is also associated with a severe flexion deformity, which is a major problem for her because she has severe wrist pathology as well. The goals of the surgery include relieving the patient of her pain and to release the elbow and to resolve as much as possible the approximate 45° to 50° flexion contracture. Dr. Morrey demonstrates his surgical approach and shows how to perform ulnar nerve dissection and lateral dissection, establish the humeral and ulnar canals, perform radial head resection, cement the implant components, and perform elbow closure.

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