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

The patient may receive general anesthesia (unconscious, no pain) or regional anesthesia that prevents the arm from feeling pain. Patients receiving regional anesthesia are also given medicine to help them relax during the operation.

The orthopedic surgeon makes an incision, 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), along with any damaged tissue.

The orthopedic surgeon then drills out a portion 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 the 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 orthopedic surgeon closes the wound with stitches, applies a bandage, and might place the arm in a splint for stability.

Indications

Elbow replacement surgery can be performed when the patient’s joint has been severely damaged. Causes of damage include:

Osteoarthritis
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
Poor result from previous elbow surgery

Risks

Risk for any surgery include:

Bleeding
Infection
Blood clot

Risks of elbow replacement surgery include:

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

Expectations after surgery

The patient 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

Physical therapy, starting with gentle flexing exercises, will be prescribed. Patients who have a splint typically start therapy a few weeks later than those who do not.

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

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

The patient should not lift more than five pounds with the operated arm, even when 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:3/9/2007
Reviewed By:Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network.

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