• INTRODUCTION
    • Elbow arthroplasty is a relatively infrequent orthopaedic procedure that can be performed in multiple ways according to the type of prosthesis that is used and the needs of the individual patient.
  • STEP 1 PREPARATION AND POSITIONING OF THE PATIENT
    • Place the patient in the lateral decubitus position or in the supine position with the arm draped, allowing for easy manipulation of the elbow during the procedure.
  • STEP 2 INCISION
    • Palpate and mark the local osseous landmarks, ulnar nerve, and incision, and then make a posterior incision to allow 360° access to the elbow joint as well as to allow decompression or transposition of the ulnar nerve.
  • STEP 3 APPROACH—THE SUPERFICIAL LAYER
    • Perform the superficial approach, including a decompression of the ulnar nerve, and properly visualize the triceps tendon attachment on the proximal part of the ulna and both epicondyles.
  • STEP 4 APPROACH—THE DEEP LAYER
    • Mobilize the triceps to allow visualization of the articular surfaces of the ulna, humerus, and radius, while taking care to protect the ulnar nerve.
  • STEP 5 PREPARATION OF THE OSSEOUS STRUCTURES
    • Prepare the humerus and ulna in conformance with the technique that is described for the prosthesis and take care to restore the anatomical flexion-extension axis of the elbow.
  • STEP 6 PLACEMENT OF THE PROSTHESIS
    • When all trial components are in place, reduce the joint to test the stability of the elbow.
  • STEP 7 CLOSURE OF THE ELBOW
    • When all of the definitive components of the total elbow arthroplasty are in place, close the surgical wound in layers as the anatomy is restored.
  • STEP 8 POSTOPERATIVE CARE
    • After surgery, a wound dressing is applied and physical rehabilitation is started to maximize the functional outcome.
  • RESULTS
    • In our study of the mid-term results of a convertible total elbow arthroplasty, based on 58 elbow arthroplasties, patients had significant improvement in range of movement, function, and pain at 6 months postoperatively8.