Introduction
Elbow replacement surgery, also referred to as total elbow arthroplasty, is a procedure done to relieve pain and restore function when the elbow joint becomes severely damaged. During this operation, a surgeon removes damaged sections of the bones in the elbow and replaces them with metal and plastic components to essentially reconstruct the joint.
Elbow replacement surgery is typically recommended when arthritis, fractures, dislocations, or other injuries cause such extensive damage that nonsurgical treatments like medications, injections, therapy, and elbow braces fail to provide adequate pain relief or improvement in function. By replacing the damaged bones and cartilage, elbow replacement surgery aims to significantly reduce pain and stiffness while restoring mobility to the elbow joint.
This article provides a complete overview of elbow replacement. We’ll discuss when surgery may be necessary, how the procedure works, what recovery entails, and what results to expect from total elbow arthroplasty. Whether you’re considering elbow replacement surgery or just want to learn about it, this in-depth guide covers everything you need to know.
When is Elbow Replacement Surgery Needed?
There are a few different conditions that can cause severe damage and dysfunction in the elbow joint, leading a doctor to recommend total elbow replacement surgery.
The most common reason is advanced arthritis. Osteoarthritis and rheumatoid arthritis can both affect the elbow joint, wearing away cartilage and bone over time. This causes painful bone-on-bone friction, along with stiffness that severely limits mobility. If non-surgical treatments like anti-inflammatory medications, injections, physical therapy, elbow pads and splints provide insufficient pain relief or functional improvement, elbow replacement may be considered.
Injuries such as fractures or dislocations can also cause enough joint damage to warrant elbow replacement. Fractures within the joint and complex elbow dislocations that extensively damage cartilage and ligaments often progress to traumatic arthritis. Attempts to repair the joint may fail, leaving few options aside from total elbow arthroplasty.
For those with these debilitating elbow conditions, elbow replacement surgery aims to remove damaged bone and cartilage from the humerus, ulna and radius, replacing these with metal and plastic components to restore elbow function and alleviate pain. It is generally pursued when nonsurgical approaches are ineffective and the joint damage is too advanced to heal on its own. The goal is to regain range of motion and strength in an elbow compromised by severe arthritis or injury.
How Does the Elbow Replacement Procedure Work?
During an elbow replacement procedure, the surgeon follows these main steps:
• Make an incision over the back of the elbow to expose the joint.
• Remove damaged sections of bone from the humerus, ulna and radius. These are the three bones that come together to form the elbow joint.
• Resurface the remaining bone and drill holes to secure the implants.
• Attach a metal component to the end of the humerus with a stem inserted into the bone canal. Attach a plastic component to the ulna. Connect these with a hinge.
• Repair and reattach muscles and soft tissues around the implants.
• Close the incision.
The metal implant has a smooth surface to glide easily against the plastic implant, recreating the hinge motion of the elbow. The components are made of durable materials to withstand everyday use and stress on the joint.
Total elbow replacement takes one to two hours to complete under general anesthesia. Patients are monitored closely afterward for any complications like infection, blood clots, nerve injury or implant issues.
With the arthritic or damaged joint replaced by artificial components, the goal is to get the elbow moving freely again while eliminating chronic pain. Following recovery and rehab, the new elbow joint should enable a return to normal activities.
Recovering from Elbow Replacement Surgery
The recovery and rehabilitation period after elbow replacement surgery is crucial for regaining mobility and function. Here’s what to expect:
• Hospital stay is typically 1-3 days. IV medication manages pain initially.
• The elbow is kept in a bulky bandage and splint. Stitches or staples are removed after 2 weeks.
• Restrictions on lifting and activity are highest at first. Movement of the arm, wrist and hand are encouraged immediately to prevent stiffness.
• Therapeutic exercises begin once bandages are removed. These help improve range of motion and rebuild strength.
• Physical therapy continues for 6 months up to a year after surgery. Goals include restoring full extension and flexion.
• Regular clinic visits allow the surgeon to monitor progress and watch for complications. X-rays track healing.
• Pain and swelling should gradually subside. Bruising may persist for a few weeks.
• Most patients can resume light household duties by 6 weeks after surgery. Full recovery takes a minimum of 6 months.
Rehabilitation requires dedication and patience. Support from a physical therapist maximizes outcomes following elbow replacement. With time and effort, it is possible to regain substantial function and use of the arm.
Results and Long-Term Outlook
When successful, elbow replacement surgery can significantly improve quality of life for those suffering from severe, debilitating arthritis or elbow injury. The potential benefits make the prolonged recovery worthwhile for most patients.
Within the first 6 months after surgery, patients can expect a progressive decrease in pain and increase in elbow mobility and strength. By 1 year, range of motion ideally improves to at least 100 degrees of flexion and extension. This allows functional use of the arm for common activities.
Longer term, elbow replacement typically enables the resumption of normal daily activities without significant impairment or pain. People can regain the ability to write, eat, groom, cook, and perform household chores independently. Hobbies and low-impact exercise are often possible with an artificial elbow joint.
Standard activities like lifting and carrying heavier objects may remain restricted to protect the replacement components. High-impact sports are discouraged as well. Some loss of endurance or strength compared to pre-surgery may persist.
The implants used in elbow replacement are durable, but do not quite match the longevity and stability of a natural healthy elbow joint. Well-fixed components have over 90% survivorship at 10 years. Additional surgery to replace worn components may eventually be needed for some patients down the road.
Conclusion
Elbow replacement surgery is a major procedure, but for patients with severe arthritis or elbow damage it can provide life-changing improvements in pain, mobility, and function. The surgery involves replacing the elbow joint with metal and plastic components to essentially reconstruct the joint.
Candidates for elbow replacement are those struggling with chronic pain, stiffness, and loss of function that has not responded adequately to more conservative treatments. The surgery aims to reduce pain and restore mobility to an elbow compromised by advanced arthritis, fractures, dislocations or other injuries.
The procedure does require extensive recovery and rehabilitation in order to regain strength and range of motion. If successful though, an elbow replacement can last over a decade and allow patients to resume daily activities comfortably. For those suffering with a severely dysfunctional elbow joint, total elbow arthroplasty may offer the best option to regain quality of life.
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