Elbow Replacement

Definition

Elbow replacement is surgery to replace the bones of the elbow joint with artificial joint parts (prosthetics).

Alternative Names

Total elbow arthroplasty; Endoprosthetic elbow replacement

Description

The elbow joint connects two bones:

  • The humerus in the upper arm
  • The ulna in the lower arm

The artificial elbow joint has two stems made of high-quality metal. A metal and plastic hinge joins the stems together and allows the artificial joint to bend. Artificial joints come in different sizes to fit different size people.

You may receive general anesthesia before surgery. This means you will be asleep and pain-free during surgery. Some patient may receive regional anesthesia instead. This means, you will be awake, but your arm will be numb so that you will not feel pain. If you receive regional anesthesia, you will also be given medicine to help you relax during the operation.

Your surgeon will make an surgical cut on your arm to reveal your elbow joint. Usually this is made in the back of the upper and lower arm. The surgen then removes damaged tissue and parts of the arm bones that make up the elbow joint.

A drill is used to make a hole in the center of the two arm bones. The end of the artifical elbow joint stems are placed into each bone. The two stems are attached together with a hinge.

The wound is closed with stitches, and a bandaged is applied. Your arm may be placed in a splint to keep it stable.

Why the Procedure Is Performed

Elbow replacement surgery is usually done if the elbow joint is badly damaged and you have pain or cannot use your arm. Some causes of damage are:

  • Osteoarthritis
  • Poor outcome from previous elbow surgery
  • Rheumatoid arthritis
  • Badly broken bone in the upper or lower arm near the elbow
  • Badly damaged or torn tissues in the elbow
  • Tumor in or around the elbow

Risks

The risks for any anesthesia are:

  • Allergic reactions to medicines
  • Breathing problems

The risks for any surgery are:

  • Bleeding
  • Blood clot
  • Infection

Additional risks of elbow replacement surgery are:

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

Before the Procedure

Always tell your doctor or nurse what drugs you are taking, including drugs, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

  • You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), and naproxen (Naprosyn, Aleve).
  • Ask your doctor which drugs you should still take on the day of your surgery.
  • If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see your doctor who treats you for these conditions.
  • Tell your doctor if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
  • If you smoke, try to stop. Ask your doctor or nurse for help. Smoking can slow down wound healing.
  • Tell your doctor if you develop a cold, flu, fever, herpes breakout, or other illness before your surgery.

On the day of your surgery:

  • You will usually be asked not to drink or eat anything for 6 to 12 hours before the procedure.
  • Take the medicines your doctor told you to take with a small sip of water.
  • Arrive at the hospital at the time your health care provider told you to do so.

After the Procedure

You may stay in the hospital for up to 2 or 3 days.

You may have a splint on your arm to help stabilize your elbow.

Your doctor will prescribe physical therapy to help you gain strength and use of your arm. Physical therapy will start with gentle flexing exercises. People who have a splint usually start therapy a few weeks later than those who do not have a splint.

Some people may start to have use of their new elbow as soon as 12 weeks after surgery. Complete recovery can take up to a year.

Outlook (Prognosis)

Elbow replacement surgery eases pain for most people. A second elbow replacement surgery is usually not as successful as the first one.

References

Azar FM, Calandruccio JH. Arthroplasty of the shoulder and elbow. In: Canale ST, Beatty JH, eds. Campbell‘s Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 8.

Review Date: 7/28/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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