Elbow Replacement Surgery
Overview
Elbow joint replacement, also known as total elbow arthroplasty, is a surgical procedure where surgeons replace damaged parts of the elbow with artificial implants made from metal and plastic. This operation usually involves three bones: the humerus (upper arm), the ulna, and the radius (both forearm bones).
The humerus acts as a hinge with the ulna, while the radius and ulna allow the forearm to rotate. Recent improvements in surgical methods and implant design have increased the success rate for elbow surgery, making it safer for patients needing joint replacements.
Key Points:
- Procedure Name: Total Elbow Replacement
- Main Bones Involved:
- Humerus
- Ulna
- Radius
- Material Used: Metal and plastic implants
Reasons for Elbow Joint Replacement
Doctors often recommend elbow joint replacement when someone has severe pain or loss of movement in their elbow due to certain medical conditions or injuries. Common causes include different forms of arthritis, such as rheumatoid arthritis, osteoarthritis, and post-traumatic arthritis. Inflammatory arthritis and degenerative joint disease can also damage the elbow joint, leading to significant discomfort and difficulty in moving the arm.
Fractures also frequently lead to this surgery. A break or shattered bone in the elbow that cannot heal properly may make movement painful or impossible. Sometimes, these fractures happen because of trauma, but they can also be related to bone conditions. For some, surgeons replace only a part of the elbow—like the radial head.
If the whole joint is affected, then they perform a total replacement. Surgeons reshape the ends of the bones and then insert artificial parts. These parts usually attach with bone cement and sometimes link together for added stability, especially if nearby ligaments are weak. This helps restore arm use and tries to reduce long-term pain. Below is a summary of reasons people might have this procedure:
| Condition | Possible Need for Replacement |
|---|---|
| Rheumatoid arthritis | Severe pain, joint damage |
| Osteoarthritis | Degenerative changes, reduced motion |
| Post-traumatic arthritis | Pain after injury or broken bone |
| Severe fracture | Bone cannot heal properly |
| Inflammatory arthritis | Ongoing inflammation damaging joint |
Possible Complications
Elbow replacement surgery comes with certain risks. Some people may have discomfort, joint stiffness, or weakness afterward. In some cases, the procedure does not fully bring back strength or movement. Sometimes, patients require a second surgery (reoperation) if new problems occur. Common risks include:
- Infection: Infection can develop at the surgical site or deeper in the joint.
- Implant Loosening: The artificial parts can loosen or wear out, leading to instability or pain.
- Bone Fracture: Nearby bones may break during or after surgery.
- Nerve or Blood Vessel Damage: These injuries can cause numbness, tingling, or muscle weakness.
- Dislocations or Ligament Injuries.
- Allergic reaction to surgical materials or anesthesia.
- Blood Clots: Rare, but possible.
Younger patients and those with past elbow surgeries face a higher risk of complications.
How You Get Ready
Preparing for elbow joint surgery involves several key steps. Patients usually meet with their orthopedic surgeon to discuss symptoms, have a physical exam, and review imaging results like X-rays or CT scans. Bringing a list of current medications, including blood thinners and disease-modifying antirheumatic drugs, helps the healthcare team plan safely. Questions to discuss with your care team:
- What kind of implant will be used?
- How will pain be managed after surgery (including nerve block options)?
- What kind of physical therapy will be needed?
- Are any home care or activity restrictions expected?
- Should a second opinion be considered?
The team may also need to know the patient’s medical history for the safest results.
What You Can Expect
Patients need to follow the surgeon’s steps on washing, eating, and taking medicines before surgery. Instructions may include not eating after a certain time or using a special soap. These steps help lower the risk of infection and problems during surgery.
Steps in the Operating Room
The care team explains how they will keep the patient comfortable. Most people receive a mix of general anesthesia and a nerve block to stay asleep and free from pain. Surgery takes between 1 to 2 hours. The nerve block may keep the arm numb for hours after the operation.
What Happens After Surgery
Right after surgery, staff monitor patients in a recovery space. Some people go home the same day, while others may need a day or two in the hospital. A splint or sling serves to safeguard the new joint during the healing process. A drain might prevent extra fluid from collecting near the wound. Physical therapy and at-home rehabilitation exercises support healing, and recovery time can vary among patients.
Outcomes
Most patients experience significant pain relief following the use of an artificial elbow joint. Many report improved elbow function and a better range of motion.
- Surgeons may attach implants with bone cement for stability.
- Surgeons may provide an unlinked prosthesis, depending on joint needs.
- Patients often gain strength, supporting daily activities.
- Advanced implant designs improve quality of life.
Patients are less likely to lose motion when surgeons use bone grafting and fit implants precisely.
