Elbow replacement surgery removes damaged areas of the elbow joint and replaces them with parts made of metal and plastic (implants). This surgery is also called elbow arthroplasty.
Three bones meet in the elbow. The upper arm bone (humerus) connects like a loose hinge to the larger of the two forearm bones (ulna). The two forearm bones (radius and ulna) work together to provide rotation.
Traditionally, elbow replacement surgery has had a higher rate of complications than surgeries to replace hip or knee joints. But recent advances in surgical technique and implant design have improved the success rate of elbow replacements.
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Why it's done
Your elbow can be damaged by conditions ranging from arthritis to fractures and other injuries. In many cases, the damage from arthritis and fractures can be surgically repaired. However, if the damage is too severe, replacement is typically better.
Pain and loss of motion are the most common reasons people choose to have elbow replacement surgery.
Conditions that can damage the joint include:
- Many types of arthritis
- Bone fractures
- Bone tumor
Elbow replacement procedures
In some cases, you may need a replacement of just one portion of the joint. For example, if only the head of one of your forearm bones (radius) is damaged, it can be replaced with an artificial head.
If the entire joint needs to be replaced, the ends of the bones that come together in the elbow will be reshaped. Bones are hard tubes that contain a soft center. The long, slender ends of the artificial parts are inserted into the softer central part of the bones.
If the surrounding ligaments aren't strong enough to hold the joint together by themselves, the surgeon may use a linking cap so that the artificial implants can't come apart.
Although it's rare, it's possible that elbow replacement surgery won't lessen the pain or make it go away completely. The surgery may not fully restore the movement or strength of the joint. Some people may need another surgery.
Potential complications of elbow replacement surgery include:
- Implant loosening. Elbow replacement components are durable, but they may loosen or become worn over time. If this happens, another surgery may be needed to replace the loose components.
- Fracture. The bones in the elbow joint can break during or after surgery.
- Nerve damage. Nerves in the area where the implant is placed can be injured. Nerve damage can cause numbness, weakness and pain.
- Infection. Infection can occur at the incision site or in the deeper tissue. Surgery is sometimes needed to treat an infection.
How you prepare
Before surgery is scheduled, you'll meet with your surgeon for evaluation. This visit typically includes:
- A review of your symptoms
- A physical exam
- X-rays and occasionally computerized tomography (CT) of your elbow
Some questions you may want to ask include:
- What type of implants do you recommend?
- How will my pain be managed after surgery?
- What kind of physical therapy will I need?
- How will my activities be restricted after surgery?
- Will I need to have someone help me at home for a while?
Other members of the health care team will assess your readiness for surgery. You'll be asked about your medical history and your medicines.
What you can expect
Before the procedure
Follow your surgeon's directions about bathing, eating and taking medicines the day before and the day of surgery.
During the procedure
A care team member will talk with you about how you'll be sedated for surgery. Most people get general anesthesia and a nerve block. General anesthesia puts you into a deep sleep. The nerve block numbs your arm so that pain control can continue after you wake up from general anesthesia. The surgery usually takes 1 to 2 hours.
After the procedure
After surgery, you'll rest in a recovery area for a short time. How long you stay in the hospital after surgery depends on your individual needs. Many people can go home the same day.
You may need to wear a splint or a sling for a few days or weeks after surgery. You may also need a temporary device called a drain to avoid pooling of fluids at the elbow. Your health care team will explain how to do exercises to help your recovery.
After elbow replacement, most people have less pain than they did before surgery. Many people have no pain. Most people also have improved range of motion and strength.