Elbow Replacement Surgery

What is elbow replacement surgery?

Elbow replacement surgery replaces the elbow joint with an artificial joint (also called a prosthetic joint).

The elbow joint connects 3 bones:

• The humerus in the upper arm
• The ulna and radius in the forearm (lower arm)

The type of prosthetic elbow joint needed will depend on the condition and which bone is affected.

Typically, a replacement elbow joint is made out of high-quality metal and plastic.

There are different types of elbow replacement surgery:

• Total elbow replacement, in which the entire elbow joint is replaced with a prosthetic joint implant.
• Partial elbow replacement, where only part of the joint needs to be removed and replaced with a prosthetic implant.

Why do you need elbow replacement surgery?

Elbow joint replacement surgery may be recommended for:

• Advanced elbow arthritis
• Post-traumatic advanced degeneration of the elbow
• An elbow fracture not amenable to fixation (in an elderly patient)
• Persistent joint instability after significant elbow trauma (in an elderly patient)

What are the risks and complications of elbow replacement surgery?

Elbow replacement surgery is a complicated procedure. This is because the elbow joint connects bones, ligaments, tendons and muscle that move together with great precision to control the movements of the forearm.

Like all surgical procedures, elbow replacement surgery carries some general risks, such as:

• Allergic reaction to anaesthesia
• Blood clots
• Excessive bleeding
• Infection

Some other risks and complications specific to elbow replacement therapy include:

• Blood vessel damage
• Bone break during surgery
• Dislocation of the artificial joint
• Loosening of the artificial joint over time
• Nerve damage during surgery

How do you prepare for elbow replacement surgery?

Before the operation, your doctor will review your medical history. You may also undergo some scans and tests.

Once your elbow replacement surgery scheduled, your doctor will advise you on how to prepare. In general, you need to fast 6 – 8 hours before the procedure.

Note: If you are taking any medication or herbal supplements, you should inform your doctor. You may need to adjust or stop taking some medication before the procedure (e.g. aspirin, blood thinners).

What can you expect in elbow replacement surgery?

Elbow replacement surgery is performed under general anaesthesia and you will be warded after the surgery to monitor your recovery.

Estimated duration

The procedure lasts about 2 – 3 hours, depending on the extent of the damage or degeneration of the elbow joint.

During the procedure

During a total elbow replacement surgery, the damaged joint will be replaced with an artificial joint that consist of 2 main metal components for the upper arm and the lower arm, and a (polyethylene) plastic articulation at the hinge.

In a partial joint replacement, only part of the elbow joint surfaces are replaced. Partial elbow joint replacement are typically used for an un-reconstructable elbow fracture, and hence the need to replace part of the fractured elbow joint.

After the procedure

Post-operative pain is normal after the surgery and will be managed with medication. You may need to stay in the hospital for a few days.

You may need to wear a splint for a short while after surgery and limit the use of your elbow for a while.

Care and recovery period for elbow replacement surgery

The recovery process after elbow replacement surgery is different for everyone. The length and extent of recovery will depend on your health and the type of the surgery.

Usually, you will need some time to regain your full strength and normal activity. Physiotherapy is an important to regain strength and use of your arm. This will include gentle flexing exercises that help you to work on your range of motion.

In most cases, it takes about 4 – 6 weeks to begin using your elbow for simple functional activities like eating, showering, typing and driving. Full recovery can take up to a year.

With an elbow replacement, you will likely feel less pain and be able to use your arm better, but there will be limits to your strength.

To maintain the elbow replacement and prevent it from breaking or loosening, it is usually advised that you avoid:

• Playing contact sport
• Lifting heavy weights

With good care and regular follow-ups, your new elbow can last many years.