July 13, 2012
Dear Mayo Clinic:
I'm 65 years old and have rheumatoid arthritis in my elbow that causes me a lot of pain. My doctor recommended that I have elbow replacement. What does this surgery involve? What is the recovery like, and what can I expect afterward?
Rheumatoid arthritis is one of the most common reasons for elbow replacement surgery. The procedure is often done for pain relief, and it is typically quite effective in reducing pain. Recovery from the surgery usually takes several months. Although you cannot perform strenuous activities with your elbow after elbow replacement surgery, you should be able to do most daily activities without discomfort.
Your elbow is a complex joint that allows you to rotate your forearm, as well as perform pushing and pulling movements. During elbow replacement surgery, the damaged joint is removed and an artificial joint is put in its place. To do this, the ends of the two bones that make up your elbow joint — the humerus in your upper arm and the ulna in your forearm — are removed and replaced with an artificial joint. The artificial joint includes metal stems that are inserted into the soft middle part of the arm bones. These stems hold the new joint in place.
The risks of elbow replacement surgery, including infection and nerve injury, are similar to the risks of any surgery around the elbow. But these risks are low when the procedure is performed by an experienced orthopedic surgeon. Bleeding is not typically an issue in elbow surgery.
Following surgery, a dressing is placed on the elbow and patients use an arm sling for a week or two. Within those first two weeks, patients are encouraged to move and bend their elbow to maintain and/or improve the joint's range of motion.
Recovery from elbow replacement usually takes about six to eight weeks. About six weeks after surgery, a follow-up appointment is scheduled with the surgeon to check healing. At that time, the range of motion with an elbow replacement typically is good and most of the pain is gone, although full healing may take up to six months for some people.
As mentioned earlier, elbow replacement is often done for people who have rheumatoid arthritis, as in your case. Some people also may need an elbow replacement as a result of a traumatic injury. In most cases, the purpose is to provide pain relief and improve the elbow's range of motion. An elbow replacement cannot completely replace a working elbow, and the artificial joint should not be used for activities that place excessive strain on the elbow. For example, sports such as golf and tennis would not be good choices for someone who has had an elbow replacement, nor would activities that involve lifting more than about three to five pounds.
An artificial elbow joint can, however, allow people to return to many of their normal routines without elbow pain. Getting dressed, lifting groceries, typing, taking a quart of milk out of the refrigerator and other daily activities should not be a problem for people who have an artificial elbow joint. In addition, physical activities that do not put stress on the elbow, such as running and walking, do not pose any concerns.
For many people in your situation, elbow replacement surgery can be a good treatment option. Talk to your doctor or an orthopedic surgeon who has experience performing these surgeries to find out more details and to determine if it is the right choice for you.
— Scott Steinmann, M.D., Orthopedic Surgery – Shoulder, Elbow, and Hand Surgery, Mayo Clinic, Rochester, Minn.