Elbow Replacement

In this surgery, the aim is to remove damaged parts of the ulna and humerus. Then, the surgeon replaces the damaged area with an artificial part. The artificial component is made up of a plastic and metal hinge. The stems whose one ends are fixed into them go inside the hollow part of bone during this surgical procedure.

Elbow replacement is a very effective surgery to relieve pain and regain the functions of the elbow in patients with arthritis, especially among patients suffering from rheumatoid arthritis.

In Elbow Replacement surgery, the doctor replaces the damaged parts of the humerus and ulna with artificial components; elbow joint is made of metal and plastic hinge with two metal stems, which fit the bone’s hollow part called the canal.

The metal replacement components are made of chrome-cobalt alloy or titanium and the liner is plastic while the bone cement is made of acrylic. Elbow Replacement Surgery is best treatment for damaged elbows.

There are different types of elbow replacement and component of different sizes. Some partial elbow replacements are used in specific situations. The different options will be discussed with the patient before finalizing.

When is it needed?

The elbow problems that bring about the need for this surgery are:

• Osteoarthritis: wear and tear leads to softening and wearing away of the cartilage that cushions the elbow. The bones rub against each other causing pain and stiffness.
• Rheumatoid Arthritis: the synovial membrane surrounding the joint inflames and thickens, damaging the cartilage causing cartilage loss, pain and stiffness.
• Post-Traumatic Arthritis: This follows a serious elbow injury where the bones surrounding the elbow fractures or torn elbow ligaments might damage the articular cartilage over time. Elbow pain and limited elbow function ensues.
• Osteonecrosis: deficiency of blood supply to the bone causes elbow joint to deform.
• Severe elbow fractures, osteoporosis and non-healing elbow fractures are other reasons.
• Instability: Ligaments holding the elbow joint together are damaged and doesn’t work well, makes it prone to dislocation. An injury can also cause instability.

Pre-Procedural activities

• Preparation for surgery is by taking blood tests, ECG, MRI or X-ray and a physical examination of the elbow is done.
• Inform the doctor of the medications and supplements, patient presently takes.
• Refrain from eating and drinking 6-12 hours prior to procedure.
• Prepare your home for adjustments to post-surgery life, as per doctor’s recommendations.

During procedure

• Patient will be given anaesthetic before the total elbow replacement surgery, which might be:
  • Regional: Numb the arm and shoulder region
  • General: Puts patient to sleep
• The surgeon will begin by making an incision at the back of the elbow and then the muscles are moved aside to get access to the bone.
• The scar tissue and spurs around the joint are removed and the humerus is prepared to fit the metallic implant to replace that side of the joint.
• Similar process is employed for the ulna too.
• The replacement stems are placed into the humerus and ulna bones and placed using cement and a hinge pin connects the stems.
• Once this wound closes, padded dressing is placed to protect the incision, as it heals.

Post-Procedural Activities

• The patient usually takes a couple of days to recover.
• The doctors will take the required measures to control any blood-clotting situation, pain and swelling.
• The doctor will provide training to the patient and the caretakers on how to handle things.
• Doctor will need to see you at a follow-up appointment after a few days.
• You might have to follow an exercise regimen, as instructed by the doctor or physical therapist.