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Elbow Replacement Surgery: What is it and how is it done?


There are three main bones that make up the elbow’s hinge joint: the lower end of the upper arm bone (humerus) connected to the upper end of the lower arm’s bones (radius and ulna). Several ligaments hold these bones together, while articular cartilage covers the elbow joint to facilitate better movement. 

All these structures work together to keep the elbow strong and stable while providing maximum flexibility and mobility. However, specific injuries and conditions can compromise the elbow joint’s function. 

Fortunately, there are a number of procedures available to treat and manage these kinds of diseases. One such example is an elbow replacement surgery or elbow arthroplasty. Read on below to get accurate answers to your burning questions before you undergo such a procedure. 

When is an elbow replacement surgery recommended?

An elbow replacement surgery treats moderate to severe elbow conditions by replacing the damaged joint with artificial implants. Doctors perform this procedure to reduce pain and restore function that has been initially damaged by one or more of the following diseases:

  • Osteoarthritis

-the gradual fraying of the articular cartilage that protects the elbow joint. As the cartilage gets damaged over time, the bones in the joint will rub against each other during movement, furthering injury and destruction. 

  • Rheumatoid arthritis

-an autoimmune condition wherein the body’s own immune system attacks the healthy tissues of the joint. It can damage several joints in the body, including the elbow, causing chronic pain and deformity.

  • Bursitis

-a condition that happens when the elbow’s olecranon bursa (a thin, fluid-filled sac) starts to swell due to irritation, injury, or overuse.

  • Severe fracture

-a broken bone in the elbow, which can either be an olecranon, radial head, or distal humerus fracture. Most fractures only need non-surgical treatment options. However, displaced elbow fractures (when the bones move out of place) may require surgery to reposition and reconstruct the broken bone.

  • Traumatic injury

-traumatic injuries, like accidents, can cause severe fractures or develop into osteoarthritis over time.

  • Overuse injury

-these are elbow joint damages sustained through repetitive motion or repeatedly putting too much pressure or stress onto the elbows. Some examples include the golfer’s elbow and tennis elbow.

  • Chronic instability

-a severe dislocation in the elbow joints caused by trauma or multiple fractures, thus making it impossible to align and reconstruct without artificial implants.

These conditions can damage the elbow joint, causing pain, inflammation, and mobility problems. Generally, physicians can manage these symptoms using conservative methods, such as medications and physical therapy. But if it doesn’t get better with traditional techniques, then they may eventually resort to surgical options, such as an elbow arthroplasty.

How is elbow replacement surgery performed?

Before the surgery, the doctor will conduct a full medical evaluation to determine if the patient is healthy enough to undergo such a procedure. The physician will also perform a medical history review to know your current illnesses and the medications you’re taking. 

In most cases, patients are put under general anesthesia to keep them in a sleep-like state during the whole procedure. Here’s how most elbow replacements go:

  • The surgeon will create an incision at the back of the elbow and move the muscles aside to access the hinge joint. 
  • They will then remove the damaged parts of the elbow, scar tissues, and bone spurs. Next, they will prepare the humerus and ulna by smoothing out or reshaping them to fit the prostheses properly.
  • The metallic artificial joints will be placed into the humerus and ulna. It may either be linked (a hinge implant connects the two metal stems) or non-linked (the two stems are connected using the patient’s ligaments).
  • After that, the replacement joints will be cemented in place to provide stability. The incision will be closed, and a padded dressing will be placed over it.
  • Sometimes, your physician will place a draining tube inside to avoid fluid build-up. It will be removed after a week.

Once the procedure is done, you will be placed in a recovery area to be monitored by your physician or other healthcare providers. 

FAQ on elbow replacement surgery

How long does the procedure take?

The whole procedure usually takes at least one to two hours. It can take up more time for complicated cases or severe conditions.

Is an elbow replacement operation painful?

A nerve block or general anesthesia will keep you pain-free and comfortable during the entire procedure. 

However, once the anesthesia wears off, you’ll feel a considerable amount of pain and discomfort, especially in the elbow area. These are all normal since your body underwent surgery and is healing. Your doctor can give you certain medications to keep the pain at bay.

Do I need to stay in the surgery center after an elbow replacement?

Most elbow replacement surgeries are performed in an outpatient setting, including  our outpatient surgery center. This means that your doctor can discharge you after a few hours of rest in the recovery area, provided your vitals are stable. 

In some complex cases, your physician may need you to stay in the hospital or surgery center for at least a day or two.

What are the do’s and don’ts after elbow replacement surgery?

Before you go home, your doctor will provide instructions on how to care for your wound and newly-replaced elbow. This may include the following:

  • Wearing a splint or sling for at least a week or two to keep the elbow immobilized so it can heal properly.
  • Taking pain medications and antibiotics to help manage the symptoms and prevent complications.
  • Take a leave off of work for at least a week or two. You should spend the first few days resting and avoiding activities that can strain the healing arm.
  • Taking physical therapy classes to start regaining arm strength and functionality. Your doctor will tell you when it’s safe to undergo rehabilitation.

Most physicians allow patients to resume light activities and use their elbows 12 weeks after the surgery. However, there may still prohibit other activities, such as strenuous workouts or lifting heavy things.

How long does it take to recover from the procedure?

You may start regaining your elbow’s normal function once you start rehabilitation. However, full recovery may take at least a year or two. 

Is elbow replacement surgery an effective treatment option?

Studies suggest that most patients who underwent total elbow replacement experienced improved function and overall quality of life. Additionally, the research found that 80%-90% of elbow arthroplasty implants have a survival rate of 5 to 10 years.

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Raleigh Orthopedic Surgical Center一your most trusted care facility for all orthopedic conditions

Raleigh Orthopaedic Surgery Center is both the largest and most modern ambulatory surgery facility in Eastern North Carolina to specialize exclusively in orthopaedics. Our patients receive outstanding patient satisfaction, superior clinical outcomes, and reduced costs. 

Our outpatient orthopedic surgery center employs top-tier Raleigh orthopedic surgeons to ensure quality care, treatment, and services like no other. Call Raleigh Orthopaedic Surgery Center at 919-719-3070 for more information.

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.