Health Encyclopedia

Elbow replacement

Definition

Elbow replacement is surgery to replace the bones that make up the elbow joint with artificial joint parts (prosthetic components).

Alternative Names

Total elbow arthroplasty; Endoprosthetic elbow replacement

Description

You may receive general anesthesia (in which you are asleep and not feeling any pain) or regional anesthesia (in which you do not feel any pain in your arm). If you receive regional anesthesia, you will also be given medicine to help you relax during the operation.

The doctor makes a surgical cut, usually in the back of the upper and lower arm, to expose the elbow joint. The surgeon removes the lower end of the bone in the upper arm (humerus) and the upper end of the large bone in the lower arm (ulna). Any damaged tissue is also removed.

The surgeon then drills out part of the center of the humerus and ulna, and inserts one part of the artificial joint into each bone. The artificial joint consists of two stems made of high-quality metal. They are joined together with a metal and plastic hinge that allows the artificial elbow joint to bend. The artificial joints come in different sizes to fit each patient.

Usually, bone cement is used to hold the stems in place.

The surgeon then attaches the two stems together with the hinge system. The wound is closed with stitches. A bandage is applied, and the arm may be placed in a splint for stability.

Indications

Elbow replacement surgery is typically performed if the elbow joint is severely damaged and you are experiencing pain or loss of motion. Causes of damage include:

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

Risks

Risk for any surgery include:

Bleeding
Blood clot
Infection

Risks of elbow replacement surgery include:

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

Expectations after surgery

You may stay in the hospital for up to 3 - 4 days. A splint may be used after surgery to help stabilize the elbow. Elbow replacement surgery relieves pain for most patients.

Convalescence

Your health care provider will prescribe physical therapy, starting with gentle flexing exercises. Patients who have a splint typically start therapy a few weeks later than those who do not.

You will need help with everyday activities, such as driving, shopping, bathing, meal preparation, and household chores, for up to 6 weeks.

Some patients may begin to regain function of the elbow as soon as 12 weeks after surgery. However, additional recovery can take up to a year.

Do not lift more than 5 pounds with the operated arm, even after you have fully recovered.

References

Rolf O, Gohlke F. Endoprosthetic elbow replacement in patients with solitary metastasis resulting from renal cell carcinoma. J Shoulder Elbow Surg. 2004;13(6):656-63.

Van der Lugt JC, Geskus RB, Rozing PM. Influence of previous open synovectomy on the outcome of Soutdr-Strathclyde total elbow prothesis. Rheumatology. 2004;43(10):1240-5.

Review Date:7/17/2008
Reviewed By:Andrew L. Chen, MD, MS, Orthopedist, The Alpine Clinic, Littleton, NH. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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