Elbow Replacement

What is a Elbow Replacement?

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

The elbow joint is made up of 2 bones:

  • 1 from the upper arm (the humerus)
  • 1 from the lower arm (the ulna)

The artificial elbow joint has 2 main parts – each made of high-quality surgical grade metal. One part replacements the end of the humerus, and the other part replaces the end of the ulna.

A metal and plastic hinge joins these parts together and allows the artificial joint to bend.

Artificial joints come in different sizes to fit different-size people.

Also known as

  • Total elbow arthroplasty
  • Endoprosthetic elbow replacement

Who is this operation for? 

An elbow replacement is for people who suffer from painful conditions at the elbow that have not responded to other treatment. Common reasons for elbow replacement include:

  • Arthritis at the elbow (osteoarthritis or other arthritis, eg rheumatoid)
  • Trauma
  • Disruption to blood supply to the elbow (avascular necrosis)

What are the benefits of the operation?

  • Reduction in pain at the elbow
  • Improved function of that arm

Risks of not having the surgery

  • Continued pain
  • Continued disability

Complications

The risks and complications of a Elbow Replacement include:

  • RisksThe risks for any anaesthesia are: 
    • Allergic reactions to medicines 
    • Breathing problems The risks for any surgery are: 
    • Bleeding
    • Blood clot
    • InfectionAdditional 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
    • Need for further surgery

Before the operation

Preadmission Clinic | Preparing for Surgery

Before your operation, you will be seen at the Preadmission clinic to make sure you are fit for the operation and all the necessary tests are performed in preparation for the operation.

During the visit, you will be seen by a

  • Doctor
  • Nurse
  • Anaesthetist (if necessary)

Tests

Tests that may be ordered for you include:

  • Blood tests
  • Xray of your Chest
  • Urine Test
  • ECG

Preparing Your Skin

Your skin should not have any infections or irritations before surgery. If either is present, contact your orthopaedic surgeon for a program to improve your skin before surgery.

Tip

Carry a list of your medications with you including the name, dosage and how often you take it.

Medications

Our doctors will advise you which medications you should stop or can continue taking before surgery.

Get some help from your friends and family

Whilst recovery from this operation is generally quite fast, you will not be able to use that arm very well during the healing process. You may wish to organise some help from family or friends in daily tasks, such as cooking and driving in the first weeks after the operation.

About the Operation

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

Your surgeon will make an incision (cut) to expose your elbow joint. Usually this incision is made in the back of the upper and lower arm. 

  • Your surgeon will remove the sections of the humerus and the ulna that make up your elbow joint. 
  • Any damaged tissue will also be removed. 
  • Then your surgeon will drill out part of the center of the humerus and ulna. An end of the artificial joint stems will be inserted into each bone.
  • Usually, bone cement is used to hold the stems in place. 
  • Next, your surgeon will attach the 2 stems together with the hinge. 
  • Your incision will be closed with sutures (stitches). It will be bandaged, and your arm may be placed in a splint to keep it stable.

After the Operation

After the operation, you are cared for in the Theatre Recovery room. You will usually only spend 1-2 hours in the recovery room.

Most people wake up fully when back in their rooms on the ward. Whilst on the ward, the nurses will take care of your every need. It usually takes a few hours to recover fully from the anaesthetic, and the nurse with regularly check on your recovery.

You will receive pain relief and antibiotics during your time on the ward. 

After approximately 24 hours, any drains in the wound will be removed, and the bandage over the arm removed.

Recovery and Rehabilitation 

Over the first 6 weeks post-surgery, exercises that encourage gentle bending and straightening of the elbow will be encouraged by a physiotherapist. They can provide exercise plans that are individualised. During this time, heavy lifting is discouraged. 

After 6 weeks, exercises are aimed at building strength in the muscles around the elbow. Follow up visits with surgeons are arranged for 6 weeks post-surgery, then for months down the track.

F.A.Q.s | Frequently Asked Questions

What are the alternative treatments to having a Elbow Replacement?

Are there important things I need to tell my doctors?

  • Redness, swelling or warmth around the cut 
  • Leakage from the cut 
  • Fever and chills. 
  • Severe elbow pain that is not relieved by prescribed painkillers. 
  • Sudden sharp pain and clicking or popping sound in the elbow joint 
  • Loss of control over arm movement 
  • Loss of arm movement 
  • Tingling or loss of sensation anywhere in the arm
  • Further surgery planned for the future i.e. dental work, bladder catheterisation, examinations of the bowel, bladder, rectum or stomach.

What are the bones of the elbow?

The elbow is a hinge joint, formed by the end of the arm bone (humerus) and the end of the forearm bones (radius and ulna). The bones are coated in cartilage, which acts as a cushion between the two bones and allows the elbow to move.