A person with a long history of polyarticular rheumatoid arthritis is experiencing severe, dominant-side elbow pain that is interfering with personal grooming, light housework, and work-related responsibilities as a computer programmer.In addition to pain, physical findings include persistent synovitis despite ongoing medical management, limited elbow ROM, and complete loss of the joint space of the humeroulnar and humeroradial joints.Given these findings, this person is most likely a candidate for which of the following surgical procedures to relieve pain and improve daily function?
A)Synovectomy
B)Excision of the radial head coupled with prosthetic implant
C)Total elbow arthroplasty
D)Arthrodesis of the elbow

Question

Quizplus · Accepted Answer

The persistent synovitis, limited ROM, and complete loss of joint space indicate that this person has advanced arthritis in the elbow joint. Total elbow arthroplasty is the best choice for improving daily function and relieving pain in such cases. Synovectomy removes only the inflamed synovial tissue and is not appropriate for advanced arthritis. Excision of the radial head coupled with prosthetic implant is suitable for isolated radial head fractures or dislocations but not for advanced arthritis. Arthrodesis of the elbow involves fusing the bones of the joint and is typically reserved for cases of failed joint replacement or severe deformity.

A Person with a Long History of Polyarticular Rheumatoid Arthritis