Total Elbow Replacement

What is total elbow replacement?

Total elbow replacement involves replacing the elbow joint with an artificial one. This procedure is less common than total knee and hip replacement surgery but can be just as effective in relieving joint pain. 

This surgery is often recommended to patients who are suffering from severe arthritis in the elbow, and are suffering considerable pain and restricted movement (of the elbow) as a result.  

What is arthritis?

Arthritis is a group of conditions that causes damage to one or more joints. The most common type of arthritis is osteoarthritis, where there is gradual wear and tear of a joint. Some other types of arthritis are associated with inflammation of the joints.

Arthritis eventually wears away the normal cartilage covering the surface of the joint and the bone underneath becomes damaged. This causes pain and stiffness in the joint.

What are the benefits of surgery?

If your elbow replacement is successful, you should have less pain and be able to move your arm more easily.

Are there any alternatives to a total elbow replacement?

Simple painkillers such as paracetamol and anti-inflammatory painkillers such as ibuprofen can help control the pain. Supplements to your diet may also help relieve your symptoms. You should check with your doctor before you take supplements.

Regular moderate exercise can help to reduce stiffness in your elbow. A steroid injection into your elbow can sometimes reduce pain and stiffness. Sometimes it is possible to have a smaller operation to remove inflamed tissue. All of these measures become less effective as your arthritis gets worse.

What does the operation involve?

A variety of anaesthetic techniques are possible. The operation usually takes between an hour and an hour and a half.

Your surgeon will make a cut on the back of your elbow joint and remove the damaged joint surfaces. They will then replace these with an artificial elbow joint made with metal, plastic, ceramic, or a combination of these materials (see figure 1). The elbow replacement is fixed into the bone using acrylic cement.

Total elbow replacement 

What will happen during my total elbow replacement?

When you meet with your consultant surgeon they'll ensure that you have the opportunity to ask any questions you may have about your total elbow replacement, they'll discuss with you what'll happen before, during and after the procedure and any pain you might have. Take this time with your consultant surgeon to ensure your mind is put at rest. We know that having an operation of any type can be stressful so we've created a short downloadable guide that you might find useful to print off and use to write down any questions you may have. Do take this with you to your consultation.

What complications can happen?

General complications:

  • Pain
  • Bleeding
  • Infection of the surgical site (wound)
  • Unsightly scarring
  • Chest infection
  • Heart attack
  • Stroke

Specific complications:

  • Damage to nerves
  • Infection
  • Loosening
  • Dislocation
  • Fracture
  • Severe pain, stiffness and loss of use of the hand (Complex Regional Pain Syndrome)

How soon will I recover?

You should be able to go home after three to five days.

You will need to use a support for the elbow for six weeks.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice.

Most people make a good recovery, have less pain and can move their elbow better. An artificial elbow never feels quite the same as a normal elbow. It is unlikely that you will be able to fully straighten your elbow.

An elbow replacement can wear out with time.

Summary

An elbow replacement is usually suitable for people who have rheumatoid arthritis. If you suffer severe pain, stiffness and disability, an elbow replacement should reduce your pain and help you to move your arm more easily.

Acknowledgements

Author: Prof John Stanley MCh Orth FRCS (Ed) FRCSE and Mr Adam Watts FRCS (Tr. & Orth.) Illustrations: Medical Illustration

Copyright © 2010 Nucleus Medical Art. All rights reserved. www.nucleusinc.com. This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.

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