Times of India
05 April 2010
By Risha Chitlangia
New Delhi, India

Replacing a bad elbow hugely improves quality of life
Till three months back, she could barely eat with her right hand or comb her hair due to inflammation in the elbow. Even a high dose of painkillers provided little relief from the excruciating pain. But today, 55–year–old Nilima Dave, who suffers from rheumatoid arthritis, doesn’t need assistance for regular work. She recently underwent an elbow replacement surgery – a rare procedure unlike knee replacement.

Nilima was diagnosed with rheumatoid arthritis 30 years ago. It gradually started affecting her joints. The disease had left her bedridden and in 2006, she underwent a bilateral knee replacement surgery. “I couldn’t move at all. I had no other option but to get my knees replaced,” said Nilima. But just a year later, her right elbow–joint, too, got affected.

“It was very traumatic. I had just recovered and was happy to walk without support when the doctors told me the disease had started making headway in my right elbow. I gradually lost control of my hand; I couldn’t hold things. Soon, I couldn’t even eat with my right hand. I couldn’t bend my elbow,” recalls Nilima.

In January this year, Nilima underwent an elbow replacement surgery. “Very few rheumatoid arthritis patients qualify for elbow replacement. We have to be careful in selecting a patient for this. Those having excruciating pain, lack of movement and deformity are selected for it. Her condition was very bad and the inflammation had resulted in deformity of the limb,” said Dr P K Dave, head of the department, orthopaedics, Rockland Hospital.

Doctors removed the affected tendons, ligament and tissues around Nilima’s elbow. “After the affected parts are removed, we make two small holes in the humerus (arm bone) and ulna (strongest bone in the forearm). The artificial joint is then fixed in these holes and connected using a hinge pin. This gives flexibility and stability to the new joint,” said Dr Dave.

With better quality implants and improved surgical techniques, Dr Dave says elbow replacement will be a regular procedure in days to come. It drastically improves a patient’s quality of life. “At present, not many people know about elbow replacement and not all replacement surgeons do it. Those suffering elbow–related problems can consider the option. But we need to be very careful that we don’t damage a nerve or blood vessel during such a surgery,” said Dr Dave.