Elbow Replacement is a surgical procedure where the damaged bone area or cartilage in the elbow region is replaced with an artificial joint or prosthetic, as it’s commonly called, to reduce pain and stiffness caused by the damaged elbow. The elbow contains multiple moving joints which makes this a complex procedure only to be opted for if the doctor recommends it.
The elbow joint connects three major bones, namely, the humerus in the upper arm and the radius and ulna bone in the lower arm. When the artificial joint is put in, the 2-3 quality grade prosthetic or metal stems work together to create flexibility and easy movability of the elbow joint.
When is Elbow Replacement recommended?
Initially, the elbow replacement was a common treatment method for patients suffering from rheumatoid arthritis (RA), but with passing years, new treatment methods involving medicine and physical therapy has been introduced to treat RA. However, certain serious RA conditions are still treated by elbow replacement. Other common causes of damaged elbow joint can be due to:
- Torn or damaged elbow tissue
- Broken or fractured elbow joint
- Tumour in elbow
- Stiffness in elbow
- Unsuccessful elbow replacement surgery in the past
Based on the symptoms you show and the intensity of the condition, your medical team will decide whether your condition requires an elbow replacement or not.
Diagnostic Tests needed
Based on the symptoms which can range from excessive pain and difficulty in movement to stiffness or visible physical growth in the elbow joint, the doctors may undergo some diagnostic tests such as a physical exam or X-Rays. The medical team may prescribe some additional tests to accurately determine the underlying condition, but generally, an X-Ray of the elbow area is enough to make the decision.
Elbow Replacement Procedure
While preparing for elbow replacement surgery, patients are requested to share the full details of their medical history with the concerned medical team. This includes ongoing or past treatment and medications including herbal supplements, vitamins etc. This is the general preparation method for this surgery.
Two weeks before the day of the surgery, patients are requested to stop alcohol or tobacco consumption along with medicines that are blood-thinners in nature. Patients suffering from heart conditions or diabetes should get themselves checked for any complications. Patients are also requested to contact the medical team regarding any special dietary regulations before the surgery.
The elbow replacement surgery is conducted under regional or general anaesthesia so the patient will feel no pain or discomfort during the procedure.
- An incision or cut is made the elbow to reveal the elbow joint
- The doctor then removes the damaged tissue, cartilage or elbow part.
- Following this, two holes are drilled in the centre of the arm bones to be connected
- The artificial joints are inserted and cemented in place. Based on the type of prosthetic used, the artificial stems cane be hinged together.
- The tissues around the new joint is restored and the incision is sewed shut.
The elbow replacement procedure can be performed using two different prosthetic types. If only a portion of the joint is damaged or broken, the surgical method can replace only that particular portion with an artificial joint. On the other hand, if the entire joint needs a replacement, both the bone ends in the elbow joint is replaced with slender artificial joints.
Bones are usually hard on the outside with a soft centre in the middle. The prosthetics are inserted in the soft centre of the bone.
The two prosthetic types used in this procedure are-
- Linked Implant &
- Un-linked Implant
Pros of Linked Implant
This type of prosthetics usually have good joint stability
Cons of Linked Implant
Movement stress sometimes can result in the implants loosening.
Pros of Unlinked Implant
With proper physical therapy, the ligaments and the muscles can strengthen and create joint stability
Cons of Unlinked Implant
Without the tissues and ligaments working together, this implant can be prone to dislocation
Risk Factors of Elbow Replacement
Certain anaesthesia complication during this routine may lead to shortness of breath, blood clot, medication reactions, or infection at the worst.
Apart from that, usual complications of this medical procedure maybe:
- Damage to blood vessels or nerves during the surgical procedure
- Loosening of the artificial joint
- Anti-bodies in the patient’s body reacting to the foreign implants
- Dislocation of the artificial joint
- Infection of the wound site
- Bone break during the surgery
Elbow Replacement Post-Surgery Care
For the initial days of the surgery, your doctor might add a splint to your elbow to keep the joints from moving. Doctors may also recommend hospital stay based on your condition to monitor the progress or success of the treatment. Certain medications will be prescribed to deal with any sort of post-operation pain or discomfort.
Home Care & Precaution
The real care and precaution start once the patient leaves the hospital. Based on your recovery, a soft or hard splint might be introduced to your arm. The usual recovery rate varies from person to person but ideally, patients can start using their arms within 12 weeks of the surgery. However, for the initial days, they might need constant round-the-clock help for their general day-to-day activities such as showering, eating etc. As for the wound or stitches, the dressing needs to be changed every day to keep the wound clean and dry, but do not put water on the wound without the doctor’s approval.
How long is the hospital stay for elbow replacement surgery?
3-5 days hospital stay.
How long will the recovery process take?
The elbow replacement procedure takes about 2-3 hours. Recovery process is mapped after the surgery is completed and might range from 6-12 weeks. From 12 weeks patients can start using the elbow joint but full recovery may take up to 1 year.
Why do I feel pain even after my elbow surgery?
Pain is normal for patients undergoing elbow surgery and it should get better over time. Pain medications can be prescribed by doctors based on the intensity of the pain.
Can I resume normal movement of my elbow?
For the first one or two weeks of the surgery, doctors recommended no or minimal usage of the hand. Within 6 weeks, physical therapy or routine chores can be started slowly and steadily, but this should be done only after doctor approval. Within 12 weeks of the surgery patients can start lifting small weights but excessive physical weight should be avoided at all costs.
My elbow is sore after physical therapy. What should I do?
This can be normal for patients trying physical therapy for the first couple of times. Usually, doctors recommend ice application to the joint for some time to reduce soreness.
How long will my elbow replacement last?
Usually, elbow replacement varies from patient to patient based on the physical activities they undertake. However, general elbow surgery can easily last you for approx. 10 years.