Elbow Replacement

What is Elbow Replacement?

Elbow replacement, or elbow arthroplasty, is a surgical procedure to replace the elbow joint with artificial parts (prosthesis). The surgery is conducted to treat severe arthritis or severe elbow fractures.

Who is Suitable for Elbow Replacement?

Candidates for elbow replacement usually suffer from conditions like

• Severe arthritis of the elbow (both rheumatoid and osteoarthritis)
• Massive, irreparable tears in the tissues around the elbow
• Severe or complex fractures of the elbow joint, especially in older adults
• Elbow instability
• Elbow deformity
• Certain tumours in or around the elbow

Benefits of Elbow Replacement:

Some of the main benefits of elbow replacement include:

• Pain relief: By removing the source of the pain (i.e., arthritis, damaged tissue, etc.), elbow replacement often provides significant pain relief.
• Improved function: The surgery can help people regain their elbow and hand use, improving their quality of life.
• Increased strength: In some cases, elbow replacement may improve strength in the arm.
• Enhanced mobility: The procedure can help restore the range of motion in the elbow.

Types of Elbow Replacement:

There are two primary types of elbow replacement:

• Total Elbow Replacement: This is the most common type. In this procedure, the surgeon removes the parts of the bones that make up the elbow joint and replaces them with a prosthesis made of metal and plastic.
• Partial Elbow Replacement (Hemiarthroplasty): In some cases, only one part of the elbow joint is damaged and needs to be replaced. This is more common in situations like severe elbow fractures.

Alternative Options to Elbow Replacement Surgery

Depending on the specific condition, Doctors may recommend alternative treatments before considering elbow replacement surgery. Some of these alternatives include:

• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections may be prescribed to manage pain and reduce inflammation in the elbow joint.
• Physical Therapy: Physical therapy can help improve the elbow joint's range of motion and the strength of surrounding muscles. It may involve exercises, stretches, and other techniques to alleviate symptoms and improve function.
• Assistive Devices: Using assistive devices like braces, splints, or orthotics can provide support and stability to the elbow joint and alleviate symptoms.
• Activity Modification: Adjusting daily activities to minimise strain on the elbow joint can help reduce pain and prevent further damage. Avoiding repetitive movements or heavy lifting may be recommended.
• Elbow Arthroscopy: In some cases, minimally invasive arthroscopic surgery may be performed to repair or remove damaged tissues within the elbow joint. This procedure is less invasive than a full joint replacement and can provide relief in certain conditions.

What to Do Before Elbow Replacement?

Before elbow replacement surgery, the following steps are typically taken:

• A thorough medical evaluation will assess overall health, review medical history, and determine if any underlying conditions may affect the surgery or recovery.
• X-rays, MRI scans, or other imaging tests may be performed to assess the extent of damage or deformity in the elbow joint.
• The surgeon will provide specific instructions regarding preoperative preparations, such as fasting requirements, medication adjustments, and any necessary tests or consultations.
• The surgeon will discuss the procedure, potential risks, complications, and expected outcomes and address any concerns or questions.

Elbow Replacement Surgery

During elbow replacement surgery, the general steps involved are as follows:

• The patient will be given anaesthesia during the procedure to ensure comfort and pain control. This could be general anaesthesia, where the patient is asleep, or regional anaesthesia, which numbs the arm and shoulder area.
• The surgeon will make an incision over the elbow joint to access the damaged joint surfaces.
• The damaged bone and cartilage within the elbow joint will be carefully removed.
• The surgeon will then attach the artificial components of the prosthesis to the remaining bone using specialised surgical techniques. The prosthesis usually consists of metal and plastic components that mimic the natural joint.
• The incision is closed with sutures or staples, and the surgical site is dressed.

What to Expect After Elbow Replacement?

After the surgery, the patient is taken to a recovery area for monitoring and to ensure that pain is adequately managed. Physical therapy and rehabilitation typically follow to promote healing, restore range of motion, and strengthen the arm and elbow.

Elbow Replacement Recovery Plan

The recovery plan after elbow replacement surgery typically includes the following:

• Pain Management: Appropriate pain medications will be prescribed to manage pain during the initial recovery period.
• Physical Therapy: Physical therapy is an integral part of the recovery plan. It usually starts within a few days after surgery and continues for several weeks or months. The therapist will guide patients through exercises to improve the elbow joint's range of motion, strength, and function.
• Home Care: Patients will receive instructions on wound care, incision care, and any necessary precautions at home. This may include restrictions on lifting heavy objects or engaging in certain activities.
• Gradual Rehabilitation: Rehabilitation exercises and activities will gradually increase as the healing progresses. The physical therapist will guide appropriate exercises and techniques.
• Follow-up Appointments: Regular follow-up appointments with the surgeon will be scheduled to monitor progress, assess the range of motion, and make any necessary adjustments to the recovery plan.

Elbow Replacement Prognosis

The prognosis after elbow replacement surgery is generally positive. The surgery can provide significant pain relief, improve function, and restore range of motion in the elbow joint. Many patients experience a significant improvement in their ability to perform daily activities and regain their quality of life.

However, individual results may vary depending on factors such as the severity of the condition, overall health, adherence to rehabilitation, and any complications that may arise.

Elbow Replacement Risks

While elbow replacement surgery is generally safe, there are potential risks and complications involved, including:

• Infection: There is a risk of infection at the surgical site or in the joint.
• Blood Clots: Blood clots can form in the veins of the legs or arms, which can be potentially dangerous if they travel to the lungs.
• Nerve or Blood Vessel Damage: During surgery, there is a small risk of damage to nerves or blood vessels surrounding the elbow joint.
• Prosthesis Complications: Issues related to the artificial joint, such as loosening, dislocation, or wear over time, may occur.
• Pain or Stiffness: Some patients may experience persistent pain or stiffness in the elbow joint, affecting function.

Discussing the potential risks and complications with the surgeon before elbow replacement surgery is essential.

Delaying Elbow Replacement

If elbow replacement surgery is delayed, the individual may continue to experience pain, limited range of motion, and functional impairment. Delaying surgery could further damage the joint or surrounding structures, making the procedure more complex. It is important to consult an orthopaedic surgeon to determine the most appropriate timing for elbow replacement surgery based on individual circumstances and the condition's progression.