Elbow Replacement Device

Question: Discuss about theElbow Replacement Device. Answer: Elbow Replacement Device Design Features The individual prosthesis has got two parts. The humeral component which replaces the humeruss lower end in the arms upper region. The part consists of a stem that is long enough to anchor it in the hollow middle of the humerus. The other component is ulnar which substitutes the ulna's upper-end region in the forearm. The ulnar component consists of a metal stem that is short and helps to anchor the ulna component onto the hollow middle of the ulna(Wendelburg, et al., 2015). The hinge that is in between the humeral component and the ulnar components is made up of a metal and a piece of plastic. The plastic section of the hinge is strong enough to withstand any adverse conditions after the replacement. The part of the hinge is also slick. The plastic part of the hinge allows the smooth sliding of the newly formed joint against one another as the elbow is moved or rotated. The hinge enables the elbow to either bend or straightens with ease. Surgical Considerations Before surgery gets conducted, the doctor may take into account on some particular consideration in the process of a prosthesis. First, the doctor should consider moving the ulna nerve so that it does not get injured during the surgery and replacement exercise. When the total elbow arthroplasty is complete, the doctor returns the ulnar nerve to its original position. Moreover, anatomical considerations should be taken seriously since the prosthesis would involve the humerus, two forearm bones and the four articulations of the elbow joint that have got a greater degree of congruence(Bachman Cil, 2017). In such a case, the doctor shall find that the ulnar nerve usually runs straight through the groove of the humerus and cuts down into the bones medial forearm. Due to this anatomical positions, the doctor should be careful so as to minimize on the entrapment of the ulnar nerve. Anatomically, the ulnar nerve gets subjected to a transient of approximately ten percent or do display a part ial dysfunction at times. The triceps insufficiency usually gets removed virtually through the Kocher lateral-to-medial approach or the approach of the Bryan lateral-to-medial triceps-sparing. Similarly, the doctor and other specialists should take into consideration the factor of pathogenesis. In most instances, elbow arthritis may attack the joint surface destroying it through different ways like through wear and tear, causing injuries or by inflammation. The joint destruction result into the elbow stiffness, feeling of pain and renders it unfunctional or fails to function normally. The common elbow arthritis is known as the Rheumatoid Arthritis which affects the joint surface of the elbow within the five years of attack(Bartel, et al., 2016). Individuals affected by the arthritis experience a lot of pain, elbow stiffness, and reduced functionality of the elbow. Also, the affected individuals have hard moments on sleeping on the arm whose elbow is affected, and they commonly cannot rotate the elbow freely. Another symptom is that when the affected individuals elbow gets moved, he or she feels the grinding effect. The doctor should consider all these factors before undert aking the surgery of the elbow and do a joint replacement. Additionally, epidemiology is another important factor to be considered by the doctor. During the prosthesis, for instance, total elbow arthroplasty which gets usually conducted on the elbow joint surfaces which severely affected by rheumatoid arthritis and on the elbows having fractures of the distal humerus(Henning Teare, 2014). The doctor should have adequate knowledge that occasionally the elbow fractures constitute roughly four percent of total fractures on the patients elbow. The specialist should have knowledge that mostly fractures affects the boys aged between five to ten years. On the contrary, the prosthesis of total elbow arthroplasty gets done in women aged sixty-five years having the distal humerus breakages. Besides, the surgical interventions are quite essential in handling the distal fractures of the humerus in cases where the assessment gets conducted on the type of fracture, what soft tissues is affected, the stability of the joint and the bones integrity. The specialist should consider this factor since the surgical intervention is a usual recommendation for the elbow joints that are severely affected by rheumatoid arthritis(Kane, et al., 2016). Occasionally, the elbow replacement gets conducted so as to restore the functionality of the joint through the removal of the tissue scars, promoting muscles balancing, and doing the joint replacement in cases of a completely affected elbow. Finally, some considerations factored after the surgical process is complete. Some the considerations include the probability of developing an infection after the implantation. Also, the risk for joint dislocation from the original place should get considered too. Lastly, the consideration whether the prosthetic procedure would result in joint loosening or not(Brunelle Weinstein, 2016). Access During the surgical process, the approach of the Bryan-Murray gets applied. An incision, 15cm, which is centered laterally into the medial epicondyle and that of the olecranon tip is made straight. The ulnar nerve gets located first and then moved to have it protected from accidental damage. Immediately after the administration of the anesthetic and preparation of the elbow, an incision which is approximately three inches made above and below the elbow(Khowaylo, et al., 2015). The incision should get done across the medial on the ulnas proximal. The incision which is about three inches above and below the elbow facilitates access to the affected joint without destroying the vital muscles which play a crucial role in the elbows movement. Materials The following biosynthetic materials formed parts of the replacement device; the polymers which would serve as the articulating surfaces and also as the bone cement. Besides, the metals would form stems of artificial components of the humerus and the ulna(Pressacco, et al., 2016). In certain circumstances, the polymer substances get substituted with the stronger ceramic materials. Peripheral Devices Some of the peripheral devices include the humeral and ulnar components, the hinge and bearing. References Wendelburg, K., Tepic, S. and Tepic, I., Kyon Ag, 2015.Elbow joint prosthesis and method for implantation. U.S. Patent 9,023,110. Bachman, D. and Cil, A., 2017. Current concepts in elbow arthroplasty.EFORT Open Reviews,2(4), pp.83-88. Bartel, D.L., Figgie, M.P., Hotchkiss, R.N., Lipman, J.D., Lo, D. and Wright, T.M., New York Society For The Ruptured and Crippled Maintaining The Hospital For Special Surgery, 2016.Elbow replacement apparatus and methods. U.S. Patent 9,358,116. Henning, S. and Teare, L., 2014. Stenotrophomonas maltophilia infection: an unusual complication of total elbow arthroplasty.JMM Case Reports,1(2). Kane, P.M., Stull, J.D. and Culp, R.W., 2016. Concomitant Total Wrist and Total Elbow Arthroplasty in a Rheumatoid Patient.Journal of wrist surgery,5(02), pp.137-142. Khowaylo, A., Malayter, J., McCarthy, M.P. and Washburn, D., Acuitive Technologies, Inc., 2015.Joint Replacement or Joint Resurfacing Devices, Systems and Methods. U.S. Patent Application 14/737,697. Brunelle, J. and Weinstein, A., Synovis Orthopedic and Woundcare, Inc., 2016.Device for soft tissue repair or replacement. U.S. Patent 9,387,280. Pressacco, M., Del Negro, N., Fattori, A., Hotchkiss, R.N., Figgie, M.P., Wright, T.M., Lipman, J.D. and Lo, D., Limacorporate Spa, 2016.Elbow replacement apparatus and methods. U.S. Patent Application 15/174,533.