Orthopaedics
Total Elbow Arthroplasty (TEA) Technique Can Reduce Complications
Today, many people can be liberated from living with an elbow that becomes chronically painful and stiff. Arthritis, serious fracture, and poor healing following injury can damage joints so severely that conservative treatments fail. In total elbow replacement, or arthroplasty, a prosthesis, or implant is used to reconstruct the joint. Total elbow arthroplasty (TEA) has become increasingly popular. As research guides the improvement of implants and surgical technique, surgeons transform disability to ability and suffering to comfort.
The goal of TEA is to alleviate elbow pain associated with activities of daily living. Surgical complications can be an obstacle to resuming an active way of life, though. Our research into implant design and surgical technique helps us to determine and promote the use of the best practices and to return motion and comfort to patients.
The compilation, analysis, and summarization of medical literature is one method our surgeons use to make treatment decisions. When thousands of patients are tracked over an extended period of time, patterns sometimes emerge. If a variation in surgical technique is associated with a greater number of complications, surgeons can choose an alternative. By publishing the results of that systematic research into techniques and complications, our clinicians inform the medical community of the best surgical practices.
Damage to the ulnar nerve, which runs through a grove on the inner side of the elbow, is a complication of TEA that can affect the patient’s long-term comfort following surgery. Surgeons use different methods of handling the ulnar nerve during this procedure. Choice of technique is one variation in TEA for which evidence guiding the best practice now exists.
Chief of URMC’s Shoulder and Elbow Services, Ilya Voloshin, MD, along with colleagues from Boston University Medical Center and the Mayo Clinic recently completed research on the complications following nearly 2000 TEA operations. They found that a surgeon’s method of handling the ulnar nerve indeed leads to variable patient comfort. The team was able to determine the safest method from this large sampling of patients.
Armed with this knowledge, surgeons around the world can now consider adopting the method of ulnar nerve handling that leads to the best patient outcomes. The TEA patients of today experience better results than those just a few years ago. Through research, TEA will continue to become safer for those in need of elbow reconstruction.