LRE Joint Replacement
Lateral resurfacing elbow (LRE) joint replacement is a procedure to replace the articular surfaces within the lateral compartment of the elbow joint damaged by injury or arthritis.
The elbow joint is formed by 3 bones, the humerus of the upper arm and the radius and ulna of the forearm. The joint has two compartments, an outer or lateral compartment where the humerus articulates with the radial bone and an inner or medial compartment where the humerus articulates with the ulnar bone. This allows two kinds of movement, a hinge movement that lifts and lowers the forearm and a rotational movement that turns the palm inside and out.
The surfaces of the bones within the joint are covered by smooth cartilage that enables the bones to glide freely over each other. When a joint has arthritis, the cartilage surface is damaged, causing pain and stiffness. This can occur due to injury, wear and tear or disease such as rheumatoid arthritis.
Severe and persistent symptoms may require a joint replacement. A total elbow joint replacement, which is normally performed, involves removal of the top of the radius and replacement of the remaining articular surfaces with artificial components to create a hinge joint. This can result in abnormal movement of the elbow joint causing malalignment and wear of the components. As arthritis is often only confined to the lateral compartment of the joint, an LRE joint replacement may be indicated which has several advantages over the total joint replacement.
The LRE joint replacement is limited to the lateral compartment and does not remove the radial head but only replaces the surfaces where the radius and humerus articulate. This preserves the natural movement of the elbow joint. Total joint replacements have large components that are not easy to replace and revision surgery does not have very good outcomes. With the LRE joint replacement, the components are smaller and long lasting as wear is minimal. Should a total joint replacement be needed in the future, it can easily be performed with good results.
For the LRE procedure, you will lie on your side with your arm supported and flexed at 90 degrees. To approach the joint, your doctor will make an incision in the back of the elbow, splitting the triceps muscle. The joint is dislocated and the articular surfaces prepared. Peg holes are made on the surfaces to receive the implants. The implants are then positioned and the joint reduced. The triceps and other soft tissues are repaired ensuring the correct amount of tension. The skin is then closed with sutures. You will require a 2-3 day stay at the hospital. Your arm will be in a sling or cast for 4-6 weeks after which you will gradually resume function of the elbow.
As with a total joint replacement, the LRE procedure may be associated with certain complications such as infection, nerve damage, elbow stiffness, loosening or dislocation of components or fracture. These are however temporary or can be treated.