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Elbow prosthesis
Elbow prosthesis


Elbow replacement

Definition:

Elbow replacement is surgery to replace the elbow joint with artificial joint parts (prosthetics ).



Alternative Names:

Total elbow arthroplasty; Endoprosthetic elbow replacement



Description:

The elbow joint connects two bones:

  • The humerus in the upper arm
  • The ulna in the lower arm (forearm)

The artificial elbow joint has two stems made of high-quality metal. A metal and plastic hinge joins the stems together and allows the artificial joint to bend. Artificial joints come in different sizes to fit people of different sizes.

You will receive general anesthesia before surgery. This means you will be asleep and pain-free during surgery. Some patients may also receive regional anesthesia. You will also be given medicine to help you relax.

A cut (incision) is made on the back of your elbow so that the surgeon can view your elbow joint. The damaged tissue and parts of the arm bones that make up the elbow joint are removed.

A drill is used to make a hole in the center of the two arm bones. The end of the artificial joint are usually glued in place into each bone. They are connected with a hinge. The tissue around the elbow is repaired.

The wound is closed with stitches, and a bandaged is applied. Your arm may be placed in a splint to keep it stable.



Why the Procedure Is Performed:

Elbow replacement surgery is usually done if the elbow joint is badly damaged and you have pain or cannot use your arm. Some causes of damage are:



Risks:

Risks of this procedure include:

  • Allergic reactions to medicines
  • Allergic reaction to the artificial joint
  • Bleeding
  • Blood clot
  • Blood vessel damage during surgery
  • Bone break during surgery
  • Breathing problems
  • Dislocation of the artificial joint
  • Infection
  • Loosening of the artificial joint over time
  • Nerve damage during surgery


Before the Procedure:

Always tell your doctor or nurse what medicines you are taking, including drugs, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

  • You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), and naproxen (Naprosyn, Aleve).
  • Ask your doctor which drugs you should still take on the day of your surgery.
  • If you have diabetes , heart disease, or other medical conditions, your surgeon will ask you to see the doctor who treats you for these conditions.
  • Tell your doctor if you have been drinking a lot of alcohol (more than 1 or 2 drinks a day).
  • If you smoke, try to stop. Ask your doctor or nurse for help. Smoking can slow wound healing.
  • Tell your doctor if you develop a cold, flu, fever, herpes breakout, or other illness before your surgery.

On the day of your surgery:

  • Follow instructions about not drinking or eating anything for 6 to 12 hours before the procedure.
  • Take the medicines your doctor told you to take with a small sip of water.
  • Arrive at the hospital on time.


After the Procedure:

You may stay in the hospital for up to 2 or 3 days.

You may have a splint on your arm to help keep your elbow still.

Physical therapy will be needed to help you gain strength and use of your arm. It will start with gentle flexing exercises. People who have a splint usually start therapy a few weeks later than those who do not have a splint.

Some people can start to use their new elbow as soon as 12 weeks after surgery. Complete recovery can take up to a year. There will be limits to how much weight you can lift. Lifting too heavy of a load can break the replacement elbow or loosen the parts. Talk to your doctor or nurse about your limitations.



Outlook (Prognosis):

Elbow replacement surgery eases pain for most people. A second elbow replacement surgery is usually not as successful as the first one.



References:

Cooney WP, Morrey BF. Elbow arthroplasty: Historical perspective and emerging concepts. In: Morrey BF, Sanchez-Sotlo J. The Elbow and Its Disorders. 4th ed. Philadelphia, PA; Elsevier Saunders; 2009:chap 51.

Throckmorton TW. Shoulder and elbow arthroplasty. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 12.




Review Date: 9/8/2014
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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