Verified By: Dr. Gautam Tawari (Specialist in Arthroscopy, Sports Surgery, Upper Limb & Hand Surgeries)
What is Elbow Replacement?
The elbow has several moving parts, which help to balance each other and control the movements of your forearm. Your elbow can be damaged by rheumatoid arthritis and traumatic fractures. In such cases, the damage can be surgically repaired but if the damage is extensive, your physician might recommend elbow replacement surgery. Pain is a common reason why most people choose to have elbow replacement surgery.
An elbow replacement surgery is a surgical procedure used to replace your elbow with an artificial joint, made from two implants which are attached to the bones in your arm, and the metal and plastic hinge joins the implants together.
What is the Anatomy of an Elbow?
The elbow is a hinge joint which consists of three bones:
- The humerus (upper arm bone)
- The ulna (lower forearm bone)
- The radius (lower forearm bone on the thumb side)
In a healthy elbow, synovial membrane produces a small amount of fluid, to lubricate the cartilage and eliminate any friction as you bend and rotate your arm. Muscles, ligaments, and tendons help to hold the elbow joint together.
What are the Types of Elbow Replacement?
You may need a replacement of just one portion of the joint or a whole portion of the joint. In case the head of one of your forearm bones (radius) is damaged, it can be replaced with an artificial head i.e. partial elbow replacement surgery. If you require total elbow replacement surgery (whole joint needs to be replaced), then the ends of the bones which come together in the elbow should be removed. Bones are hard tubes containing a soft center, and the long and slim ends of the artificial joint, are inserted into the softer central part of the bones.
The two types of prosthetic devices that are used in the surgery are:
Linked – This type of prosthesis will act as a loose hinge because all the parts of the replacement joints are connected. This provides good joint stability, but the movement can sometimes result in the prosthesis becomes loose in the arm bones.
Unlinked – This type of device comes in two separate pieces that are not connected. This design will depend on the surrounding ligaments, to help in holding the joint together which makes it more prone to dislocation.
Who Requires an Elbow Replacement?
Elbow replacement surgery is required if the elbow joint is badly damaged or you cannot use your arm because of severe pain. Some causes of damage are:
- The poor outcome from past elbow surgery
- Rheumatoid arthritis
- Severe Fractures
- Damaged or torn tissues in the elbow
- Tumor in or around the elbow
- Stiff elbow
How is the Elbow Replacement Performed?
Elbow replacement surgery is performed with general anesthesia or you will receive regional anesthesia (spinal and epidural) to numb your arm. Elbow replacement surgery takes about 2 hours and the hospital stay will last for 2 or 3 days.
Step 1 – To reach the elbow joint, your surgeon will make an incision (cut), usually at the back of the elbow.
Step 2 – After making the incision, your surgeon will gently move muscles aside to get access to the bone.
Step 3 – The damaged tissue and parts of the arm bones that make up the elbow joint are removed.
Step 4 – your surgeon will prepare the humerus to fit the metallic piece that will replace that side of the joint. The same preparation is done for the ulna. The replacement stems will be placed into the humerus and ulna bones and fixed with bone cement. The two stems will be connected by a hinge pin.
Step 5 – After the wound is closed, a padded dressing is then placed to protect the incision while it heals. Some surgeons will place a temporary tube in the joint to drain surgical fluid. This tube can be easily removed in your hospital room within a few days after the surgery.
What are the Risks for Elbow Replacement?
- Allergic reaction to the artificial joint
- Weakness or failure in the tendons of your arm
- Bone break during surgery
- Dislocation of the artificial joint
- Loosening of the artificial parts over time
Post-operative care after Elbow Replacement:
Elbow replacement reduces pain and allows your elbow to function properly. But it may not be as good as it was before the injury or disease.
- After the operation, you’ll have stitches and a bandage on your new elbow. You will also need to keep your arm in a splint to keep it stable while it heals. You must follow the instructions on how to care for your wound and elbow.
- You will require strong pain medications after the surgery because elbow replacement involves cutting skin, tendons, and bone. You will also take pain meds for 1 to 2 weeks after you go home from the hospital.
- It will take time to get adjusted to your new elbow. For instance, you will not be able to lift anything heavy for 6 weeks after surgery.
- Physical therapy is required to help your arm get stronger and move better. You will learn simple exercises for your hand and wrist to avoid stiffness and help to control swelling, such as bending and straightening your arm.
- Some people usually start using their new elbow 12 weeks after surgery but complete recovery can take up to a year. There will be limits to the amount of weight you can lift. Lifting heavy loads can break the replacement elbow or loosen the parts.
- You will need to avoid activities that can cause further injuries, such as hammering, sports events, and lifting heavyweights. With good care, your new elbow could serve you well for many years.
What is the Elbow Replacement Surgery Cost in India?
The cost of elbow replacement surgery in India ranges from USD $4500 – USD $6000. Treatment in India is affordable compared to the western countries i.e. 70% – 90% cheap due to the low-cost infrastructure while there are no compromises in the quality of the treatment. Due to our decade-old association with the hospitals in India, we ensure that you get the best hospital and surgeon for your elbow replacement surgery.
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Frequently Asked Questions:
What is the Success Rate of Elbow Replacement?
The success rate of elbow replacement surgery is 90%.
How long does it take to get the normal movements of an Elbow after the surgery?
Elbow motion is completely recovered during the first 6 to 8 weeks.
What can I expect after Elbow Replacement?
Your elbow area may feel tender for 2 to 4 weeks after the surgery. For the first week after the surgery, you will be having a soft splint on your arm to hold your elbow in place. After the incision has healed, you may need to use a harder splint or a brace with a hinge.
How long does an Elbow Replacement last?
Your elbow replacement may last for 10 years after that it can wear out.
How long before I can drive after Elbow Replacement?
Since you will suffer from limited mobility after your elbow surgery, it is not advisable to drive after the elbow surgery. Recovery varies from person to person and therefore your physician can guide you on this matter.
How should the Elbow be Positioned after the Elbow surgery while sleeping?
You should have the hand elevated in bed after the elbow surgery. Sleeping on your back is recommended with your elbow at your side resting on the bed, and the hand resting on a cushion at your side.