ELBOW ARTHRITIS TREATMENT MELBOURNE

Dr Christopher Pullen

Elbow Arthritis Treatment Melbourne

A Patient’s Guide:

 Dr Christopher Pullen – BSc(Hons), MBBS, MPH, FRACS, FAorthoA.
Orthopaedic Surgeon

“I may recommend surgical treatment if you have a painful elbow condition that does not respond to nonsurgical treatment including rest, physical therapy, medications and injections.

Prior to recommending surgery, I will undertake a thorough clinical examination, discuss your diagnosis and detail the treatment options to ensure you understand the benefits and potential complications.”

PATIENT CARE PROCESS – DR CHRISTOPHER PULLEN
Dr Pullen’s approach to your care:

1. First Appointment

Referral, consultation & testing.

2. Diagnosis

Diagnosis & treatment options.

3. Treatment Plan

Non-operative VS operative.

4. Follow up & care plan

Monitoring, pain relief & care plan.

ELBOW JOINT ANATOMY

The anatomy and function of the elbow joint

The elbow is a complex hinge joint that consists of three separate joints. Different articulations of the elbow joint (the ulnohumeral joint, the radiocapitellar joint, and the proximal radioulnar joint) allow for a wide range of movements of the forearm and hand.

Many of the muscles of both the lower and upper arm either cross or attach to at least one component of the elbow joint.

The elbow joint is made up of three bones, (1) the humerus, (2) ulna, and (3) radius. It is surrounded by a watertight sac called the joint capsule (which is filled with lubricating fluid).

Elbow arthritis can cause pain and stiffness and can become disabling in severe cases, making it difficult to perform everyday activities.

Elbow Joint Anatomy

Figure 1

ELBOW ARTHRITIS

Elbow arthritis occurs when the cartilage (a thin protective layer that covers the bones in a joint) becomes worn or damaged. Damage can occur from overuse, repetitive activities, or injury.

Types of arthritis include:

Osteoarthritis – Most commonly occurs as a result of overuse, or an injury such as a dislocation or fracture.

Rheumatoid arthritis – Is an autoimmune disease in which the body attacks the joint tissues, causing inflammation and damage.

Tennis Elbow Treatment

To diagnose elbow arthritis, Dr Pullen will perform a thorough exam. You may also need imaging tests, such as an X-ray, CT or MRI scan to diagnose elbow arthritis or rule out other problems.

ELBOW ARTHRITIS SURGERY

Dr Pullen may recommend surgery if your elbow is not responding to nonsurgical treatments.

Surgical approaches may include arthroscopic procedures, total elbow replacement and soft-tissue reconstruction of tendons, ligaments and muscles.

Dr Pullen will discuss the options with you and any risks associated with each of the following procedures:

Arthroscopic Techniques to Treat Elbow Arthritis
Arthroscopic techniques use an arthroscope (a medical instrument that has a tiny camera lens and light that allows Dr Pullen to see the bones, joints and soft tissues in the elbow).

Dr Pullen may use the arthroscopic instruments to repair, reconstruct and remove structures of the elbow through very small incision/s. Arthroscopic techniques allow for less pain and scarring and faster recovery times.

Tennis Elbow Surgery

Total Elbow Replacement
In a total elbow replacement, the parts of the elbow are replaced with artificial parts called prosthesis. Elbow replacement surgery can be very complicated and is performed in two ways: “linked” and “unlinked.”

Linked – The “linked” method places an artificial stem inside the humerus. Another stem is inserted into the ulna. Surgeons then connect the two stems with a hinge to allow for better function and range of motion.

Unlinked – The “unlinked” method can be used for individuals who have healthier soft tissues in the elbow. An “unlinked” elbow replacement does not require a hinge because the two stems are held together with ligaments, tendons and muscles that are in good condition.

The most appropriate surgical approach for you will depend on a range of factors including the scope of your injury, your general health, and your personal needs.

AFTER ELBOW ARTHRITIS SURGERY

What happens after surgery?

After the surgery you will wake up in recovery with your arm in a sling or cast. Dr Pullen will see you to discuss the results of the surgery. Your elbow will be swollen and painful. You will be given painkillers and an ice pack regime to help ease the pain.

Usually you will need to stay in hospital overnight. Most patients can go home the next day.

The next morning your bandages will be changed and depending on your particular condition and the type of surgery you had, Dr Pullen may have you begin physical therapy to improve range of motion, function and to prevent stiffness in the elbow joint.

You can shower but must keep the wounds dry. Your arm may be in a splint or cast for several weeks.

After your surgery – Do not attempt to lift or rotate the arm or elbow. During the first 2 weeks after the operation it is important that the repaired muscles do not contract when the elbow is moved as the repair may be torn apart.

Pain relief – It is normal to have pain after surgery and painkillers will be given to you during your hospital stay and to take home. A pain management plan will be discussed with you and monitored throughout your recovery process. Your pain will slowly reduce over time.

An appointment will be organised for you to see Dr Pullen in 10 to 14 days after your surgery.

ELBOW ARTHRITIS SURGERY – RECOVERY TIMELINE

The recovery period varies from patient to patient and depends on the nature and complexity of the surgery. A typical recovery timeline may include:

Timeline – After surgery Description
0  to 2 weeks You’ll be given a course of antibiotics and pain relief medicine immediately after your surgery. Your arm will be in a splint or cast to help restrict movement and protect the elbow allowing the operation site to heal.

In the first month after surgery, expect to have someone assist you with tasks around the home as you won’t have full use of your injured arm.
2 to 4 weeks  During the first 2 to 4 weeks after the operation it is important that the repaired muscles do not contract when the elbow is moved as the repair may be torn apart. Activities related to your elbow rehabilitation will be the focus. Dr Pullen and your physiotherapist will discuss the rehabilitation plan with you in detail.
3 to 6 months It usually takes between 3-6 months after surgery to achieve a significant end range strength, power, and endurance back into your elbow. Sports and lifting heavy objects will need to be delayed for an additional 3 to 6 months.

Please contact my office or your general practitioner if after surgery you have:

  • Severe pain that is not helped by the pain medication you have been given
  • Redness or swelling around the wounds
  • Fever, sweats or chills.

POTENTIAL COMPLICATIONS

The risks and complications of elbow arthritis surgery include:

  • Elbow stiffness and restricted movement
  • Infection
  • Numbness or tingling around the elbow and forearm
  • Persistent elbow and forearm pain.

Dr Pullen will discuss with you in detail the potential complications and risks in relation to your surgery.

Mr Troy Keith
Dr Christopher Pullen
BSc(Hons), MBBS, MPH, FRACS, FAorthoA.
Orthopaedic Surgeon

If you have any questions please contact my team:

Elbow Arthritis Surgery Melbourne:

Dr Christopher Pullen – Orthopaedic Surgeon

If you have any questions or would like to make an appointment, please feel free to contact my team:

Proud member of Royal Australasian College of Surgeons and Australian Orthopaedic Association.

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Elbow Arthritis Surgery Melbourne

Dr Pullen treats patients from all over Victoria in relation to elbow arthritis. He consults with patients at the following practice locations in Melbourne including East Melbourne and Ringwood.