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Excellent & Affordable Elbow Surgery with IndianMedTrip

elbow-surgery

When people experience chronic elbow pain, right solution may be much closer than they think it is. Orthopedic surgeons perform various surgeries so as to treat conditions which include inflammation & degeneration of tendons attaching elbow joints (tennis elbow), fractured or broken elbows, arthritis of elbows from both wear & tear & rheumatoid arthritis, nerve pain in elbow (cubital tunnel syndrome) & throwing injuries.

Why Undergo Elbow Surgery

Time is ripe to look for elbow surgery when rest, therapeutic exercise, ultrasound & medications have failed to reduce inflammation in elbow joints. Orthopedic surgeons in such conditions can help decide whether surgery is the right option & which type of procedure will provide the best outcome. These surgeons can effectively perform minimally invasive arthroscopic surgery or open traditional elbow surgery so as to repair fractures & resurface elbow joints using biologic tissue. Moreover, partial or complete elbow replacement can be the best alternative option for some conditions. Orthopedic surgeons can also repair or reconstruct ligaments or perform surgery to remove pressure from nerves for cubital tunnel syndrome patients.

What is a Tennis Elbow?

Tennis elbow is basically inflammation of muscle tendon located on the outside of elbow. Lateral Epicondylitis is the medical term for tennis elbow. This inflammation is eventually caused by repeated strain of muscle known as Extensor Carpi Radialis Brevis or ECRB in short. Contrary to popular belief, this condition is not specific to tennis players & can almost affect anyone whose working may strain ECRB, like such people who undertake exercise or manual labor.

Challenging Elbow Surgery

Elbow surgery is a challenging task. Not just because elbow is a relatively small & complex hinge joint, but also due to the reason that next-generation arthritis medications have created healthier patients who require more durable & longer lasting treatments including elbow joint replacement surgery. Normally, surgical options for elbow treatments are only considered when medications & other measures are unable to relieve severe pain in joint & loss of motion. Following is an overview of some common types of elbow surgeries. These can either be performed arthroscopically by using small incisions along with fiber-optic camera technologically or through an open conventional operating procedure.

  • SynovectomyThis procedure is designed to remove the synovium which is the soft membrane lining the elbow joint. Synovium produces a lubricating fluid which eliminates friction with movement of arm in healthy elbows. This synovium is found to inflame & eventually erode cartilage & cause swelling & pain among rheumatoid arthritis (RA) & other types of inflammatory arthritis patients. Removal of synovium will temporarily halt this process. Time taken for recovery following synovectomy will depend upon how this procedure was performed & amount of tissue damage which is involved. Rehabilitation following synovectomy will however take a minimum of two months time. Best candidates for synovectomy are people in early stages of inflammatory arthritis like RA with very little or no cartilage damage at all. Synovectomy procedure can significantly help improve symptoms including pain, swelling & function of the joint to near-normal. Moreover, arthroscopic synovectomy will typically result in faster & less painful recovery. However, synovectomy does not stop progression of disease. Synovium is found to re-grow & symptoms usually return after several years following surgery. Although synovectomy can be repeated, nerve injury is additionally a significant risk in arthroscopic elbow procedures due to the tight operating space which is difficult to navigate & major nerves are located close to the joint.
  • Arthroscopic DebridementThis technique is designed to remove bony growth within the elbow joint along with any loose bits of cartilage or bone. Upper end or head of radius is also removed through this procedure in some cases. Arthroscopic debridement is successfully utilized for primary & posttraumatic OA in the elbow. Recovery time including rehabilitation is generally between 12 – 24 weeks, but nevertheless depends upon how the procedure was performed & the age of the patient. Best candidates for arthroscopic debridement are people with mild to moderate OA & who are having stiffness with minor pain. People with pain throughout the full range of motion or advanced stage of disease are unsuitable for this surgical procedure. Most patients who undergo this procedure experience 80 – 95 percent of pain relief & an increased range of motion following this surgical intervention. While arthroscopic & open procedures display equally successful outcomes, arthroscopic techniques which have shown considerable improvement in the past decade, are associated with lesser pain & faster healing. However, bony growths are found to recur along with decreased range of motion following this procedure even though many patients continue to experience significant amounts of pain relief. Moreover, arthroscopic debridement like arthroscopic synovectomy also carries risk of injuries to nerves even when the operation is performed by highly trained elbow arthroscopists.
  • Elbow Interposition ArthroplastyGoal of elbow interposition arthroplasty is to relieve pain which occurs while bone surfaces are rubbing together. Ends of bones are reshaped while a small section of the patient’s Achilles tendon or another soft tissue is fitted into space between joint surfaces. Recovery time however, including healing & rehabilitation following interposition arthroplasty can be up to four months. Best candidates for this procedure are active people with posttraumatic OA, primary OA or inflammatory arthritis having too much damage for debridement but are still too young for elbow joint replacement surgery. Candidates for this procedure must also have a stable elbow with ligaments holding the bones in place alongside minimal bone loss. Elbow interposition arthroplasty can effectively relieve severe pain along with retaining some elbow function unlike an artificial joint which would loosen or dislocate transplanted tissue. Bone stock is also preserved with this procedure & which is crucial in case elbow replacement is required sometime in future. Results of this procedure however are long lasting & rarely requires total elbow replacement for at least up to 15 years. Nevertheless, elbow interposition arthroplasty does not completely relieve pain or even restore full function of the elbow & also cannot be performed on some patients with severe disease.
  • Total Elbow Replacement or ArthroplastyThis procedure is quite similar to knee or hip replacement surgery. It is designed to replace damaged part of elbow with artificial or prosthetic components. This linked elbow implant consists of two metal stems. One to fit in the humerus & the other in the ulna. These are enjoined by a cobalt-chrome hinge pin which articulates with the joint. This is an unlinked prosthesis where the ulnar & humeral components do not mechanically join, but instead rely upon the surrounding tissue for gaining joint stability. Linkable implants give surgeons an extra option of leaving the implant linked or unlinked, depending upon what they feel best during surgery. Average recovery time following total elbow replacement surgery is a minimum of 12 weeks. Best candidates for this procedure were earlier older & less active adults suffering from end-stage inflammatory arthritis. However, nowadays elbow implants are also used for OA & posttraumatic OA patients as well. But, because they normally do not last for more than a few years are therefore not recommended for people who are less than 60 years of age. Elbow replacement surgery is found to successfully relieve pain & restore motion which was lost in people with severely damaged or deformed elbow joints. But then, complication rates for elbow replacement surgery are higher than for any other joints. Although linked implants are found to ensure a stable elbow even in cases of severe bone loss, they eventually tend to loosen & quickly wear out. Unlinked elbow joint implants are found to dislocate easily & for this very reason are used less often. High failure rates have been reported overall amounting to about 25 percent at 5 – 7 years of time. This is partly due to poor tissue quality in joints & paradoxically to effects of better arthritis medications.
  • Elbow ArthroscopyElbow arthroscopy is a procedure where a small camera known as an arthroscope is placed inside an elbow through a small incision in skin & which allows surgeons view inside the joint. Subsequently, the tendon for ECRB is located & cut. Primary reason for people requiring this surgical intervention is to decrease pain & improve symptoms. Risks of this operation in general relates to anesthesia. Anesthesists will however discuss this procedure with patients prior to surgery & identify any specific risks which may be particularly important to individual cases. Elbow arthroscopy is frequently performed & is generally considered a safe surgical procedure. Patients must however make an informed decision & give consent after comprehending the possible risks, complications & side effects of elbow arthroscopy surgery.

Some Complications of Elbow Arthroscopy are Listed Below

  • Infection (in less than 1% cases).
  • Bleeding (in less than 1% cases).
  • Neuroma or swelling of nerve tissue (in less than 1% cases).
  • Nerve Injury (in less than 1% cases).
  • Stiffness of Elbow (in 1 – 2 % cases). This is self-limiting & improves over a 3 – 6 months period.
  • Complex Regional Pain Syndrome (1 in 3,000 cases).
  • Weakness of wrist (in 1 -2 % cases). This can improve with physiotherapy.
  • Partial or incomplete symptom relief.
  • Need for further surgical interventions and/or procedures. Patients must discuss further options for treatment with their doctors based upon individual progress & requirements.

Preparing for ECRB Release Surgery

It is important that patients remove all jewelry from the affected arm in preparation for ECRB release surgery. They will also need to fast (including eating & drinking) from midnight on the day prior to undergoing surgery. Pre-assessment team will sit with the patient & discuss as to which medications (in case the patient is taking) can be taken on the day of surgery. They will also provide patients with more information regarding preoperative preparations. While asking for consent, the healthcare team will invariably involve patients in all decisions about aftercare & treatment. Patients will also be asked to sign a consent form in case they will like to go ahead with the surgical procedure. This will eventually confirm that the patient has agreed to undergo the procedure after having understood all that is involved.

During the ECRB Release Surgery Procedure

Patients will be examined by the doctors of the surgical team on the day of admission, & they will mark the site of surgery & ask them to sign the consent form in case this has not already been done. Anesthetists will then review fitness for surgery & finalize the planned anesthetic regimen. The patient will be now taken to the operation theatre for the procedure to be performed under the influence of general anesthesia. Surgical procedure involves making several small incisions around the elbow so as to enable the arthroscope access the elbow joint. Following locating & accessing the ECRB muscle, the orthopedic surgeon will then eventually cut the tendon. After completion of this operation, incision sites will be stitched & dressed with sterile dressings. Patients are also given slings after completion of the procedure.

Postoperative Care

Postoperative pain is quite normal & patients will most probably receive a combination of pain-relieving medications so as to minimize pain. Patients will also be transferred to the recovery room following operation & where they will initially be closely monitored for any complications. After the observation period they will either be transferred to the orthopedic ward or ambulatory care unit. Most patients are allowed to go home on the day of surgery while some require an overnight stay at the hospital. Time for discharge from hospital will however depend upon individual circumstances & which will also be discussed with the patient before the procedure. However, patients will require someone who can drive them back home & for someone to stay with them in case they are staying overnight at the hospital facility. Patients may also be seen by an orthopedic physiotherapist in case the surgeon indicates that this is needed.

Elbow Surgery Aftercare

Elbow will usually feel stiff for the first few days after patients get home following the surgical intervention. However, this gradually improves over time. It is important for the patient to continue with the physiotherapy exercise at home in case they were given, so as to avoid risk of stiffness remaining in elbows & which will eventually reduce potential benefits that were meant to be obtained from this surgical procedure. It is also very important that patients regularly move their fingers, wrist & shoulder in order to prevent these joints from stiffening up. While leaving the dressing intact, patients must clean up & dry the area until the next follow-up appointment & which is usually about 15 days following the elbow operation. Since it is extremely essential that patients relax & maintain adequate levels of pain relief after surgery for normal recovery, they must make sure that they regularly take the prescribed painkillers. They should also seek further advice of the doctor in case they are still in pain. Patients may sign-off from work for about 1 – 3 weeks of time depending upon the nature of their work.

Elbow Surgery Follow-Up Appointments

Follow-up appointments after elbow surgery are usually conducted after two weeks & will require the patient to visit the outpatient department of the hospital & have their wounds checked & stitches removed. Dressings are also checked during this appointment & are reduced as appropriate in each case. Patients will also be reviewed by orthopedic doctors during this follow-up appointment.

Alternatives to Elbow Surgery

Need for elbow surgery is however dependent on the amount of discomfort & disability the patient is suffering as a result of his/her condition. Elbow surgery is just one possible treatment for this type of condition. Other alternative treatment options for elbow problems include physiotherapy, use of a counter-force brace or steroid injections of the tendon. These could be initially tried so as to help improve range of movement. Moreover, orthopedic doctors usually discuss these options with patients before they commit to surgery.

Affordable Elbow Surgery with IndianMedTrip

India is one of the most popular medical tourism destinations in the world today which is providing a wide range of medical procedures including orthopedic treatments like elbow surgery at reasonable costs. With cost of healthcare rising across countries around the world, India has remained a pleasant exception to this trend, especially for international patients. Vast pool of Indian doctors & surgeons are globally reputed to be some of the best & many of whom have initially trained & experienced for decades in developed countries like the UK, Canada & United States before returning to their homeland. Healthcare infrastructure in the country is at par with the best in the world & includes several internationally accredited hospital facilities ably managed by English speaking professional staff & nurses. IndianMedTrip is a leading healthcare tourism company which is based in South Asia & providing a variety of affordable medical solutions to international patients. This one-stop online health tourism platform’s seamless services begin with the first telephonic conversation & go on to identifying the best doctor or surgeon & the ideal hospital facility for the patient as per his budget. Host of other services offered by this company include assistance in obtaining medical visas for the patient & the person accompanying him/her, warm reception at the airport on arrival for treatment, convenient local travel facility, comfortable choice of accommodation which includes, budget hotels, luxury hotels or serviced apartments, scheduled appointments with doctors & treatment procedure, option for an exotic holiday at reasonable costs, follow-up evaluation checkups & an affectionate farewell at airport when the patient heads back home.

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