Elbow Replacement Surgery
The elbow is a synovial, hinge-type joint made up of 3 bones. The upper arm bone, between the shoulder and the elbow is called the humerus, with the radius and ulna forming part of the forearm and running alongside each other, between the elbow and wrist. The primary function of the joint is to position the wrist to maximise hand function. The elbow enables your forearm and wrist to rotate, as well as flex and extend.
Elbow replacement surgery is a complex procedure necessary when extreme damage occurs from things such as rheumatoid arthritis, to extreme fractures with pain being the most common reason people choose to have the procedure.
Why Would I Need Elbow Replacement Surgery?
The two main causes for replacing the elbow joint are arthritis or severe fractures. Osteoarthritis and rheumatoid arthritis are the 2 most common forms of arthritis, causing pain and difficulty moving. Elbow replacement may be a method of relieving pain and restoring movement when other medical treatments fail.
Elbow replacement surgery may be an option for someone who has an injury to the elbow that cannot be fixed, either because the bone is broken in too many places, or because the bone is not fit for fixation.
If your elbow joint is causing you pain or limiting you physically, you have probably suffered wear and tear, a condition like arthritis or damaged your elbow through an injury. Using your elbow can become increasingly painful. Common elbow complaints:
- Elbow pain
- Tennis elbow
- Tenderness on the outside of the elbow, sore forearm muscles, persistent aching, pain when grasping or holding objects
- Elbow fracture
- Pain, swelling and bruising along with stiffness around the elbow
- Arthritis of the elbow
- Pain, swelling, stiffness and lack of full motion
To diagnose your condition, your doctor will complete a thorough investigation of your elbow as well and carry out physical tests, such as bending and straightening, to determine the strength and range of movement of the elbow. You will likely be referred for imaging such as an MRI scan and an X-ray.
Although elbow joint replacement is a less common procedure than knee or hip replacement, it is just as successful in relieving pain and helping people return to everyday activities. Elbow replacement may be suggested when non-surgical options such as medication and physical therapy fail to help alleviate the persistent pain.
Your doctor may ask to see you a couple of weeks prior to the elbow replacement surgery to make sure you are healthy enough to have the surgery and make a full recovery.
You will only be offered elbow replacement surgery if your doctor believes that this will help improve your symptoms.
Elbow replacement surgery usually takes around 2 hours to perform. You will be administered a general anaesthetic and will need to stay in hospital for up to 4 nights following the operation. Your surgeon will make an incision, typically on the back of the elbow, and gently move muscles aside to get access to the joint. After removing scar tissue, your surgeon will prepare the humerus to fit the prosthetic. The same preparation is done for the ulna.
After the operation, your doctor will stitch the wound and bandage the area around your new elbow. You may be required to keep your arm in a splint in order to keep it stable whilst it heals.
Some cases may require just one portion of the joint to be replaced. For example, if just the head of one of your forearm bones is damaged, it can be replaced with an artificial head, as opposed to a complete prosthetic insert. The ends of the bones that come together in the elbow will be removed if the entire joint does indeed need to be replaced. The long, slim ends of the artificial joint are inserted into the softer central part of the bones.
There are two main types of prosthetic devices available:
This type of prosthesis acts in a hinge-like fashion, because every part of the replacement joint is connected. The stresses of movement can sometimes result in the prosthesis coming loose, but does offer a good amount of joint stability.
This device consists of two separate pieces, disconnected from each other. This design relies on the help of the surrounding ligaments to hold the joint together, which can make it prone to dislocation.
Elbow replacement surgery involves the cutting of skin, tendons, and bone, so you will require strong pain medication for 1 – 2 weeks during the recovery period.
It will take time to adjust to your new elbow and get back to carrying out simple, everyday tasks. For example, you will not be able to lift anything heavier than a cup of tea for around 6 weeks after surgery, so it is a good idea to ensure that you will have some help available.
Your doctor will provide you with some simple exercises, such as bending and straightening your arm, in order to build strength and improve your range of motion.
Elbow replacements are likely to need replacing in time due to usage. The procedure is predominantly intended to alleviate pain, sometimes taking several weeks to do so, but will also improve the mobility of your arm in the future. Following surgery, you should only partake in light physical activity and avoid lifting, as well as repetitive movements.
Your elbow and forearm may appear bruised and swollen, but this can be treated with ice packs and will disappear within a few weeks. Wearing a sling for up to 6 weeks will also help in limiting movement and therefore aiding the recovery process.
You will be asked to attend a follow-up appointment, usually 10-14 days after your operation, in which your doctor will check your recovery progress and remove any stitches leftover from your surgery (though you may have been given dissolvable stitches). Full recovery could take up to a year but you may be able to use your elbow around 12 weeks after the procedure.
Complications Following Surgery
Complications are possible, as with all surgical operations, but uncommon following elbow replacement surgery. Pre-existing chronic illnesses, however, can increase the likelihood of them occurring, so you should notify your doctor of any that you have. Some of the most likely complications and side-effects include:
- Infection- bleeding after surgery can sometimes be a sign of infection
- Injury to nerves and blood vessels
- Allergic reaction to the artificial joint, including a rash, itching and discoloration
- Stiffness or unsteadiness of the joint
- Loosening of the artificial parts
- Bleeding and blood clots
- Weakened tendons in your arm
- Pain – you will require stronger pain relief after your surgery for approximately 1- 2 weeks
- Allergic reaction to the anaesthetic
Extremely rare complications include:
- Elbow-joint infection
- Heart attack
Outlook after Elbow Replacement Surgery
Elbow replacement surgery tends to improve the long-term quality of life. Increasing mobility and missing fewer work days due to repetitive pain. Although it may need a replacement after some time, most who have elbow replacement surgery enjoy a greater quality of life in the future.
At One Healthcare we can book you in to see a specialist Orthopaedic Shoulder and Elbow surgeon, usually within 48 hours, for an initial consultation. Elbow replacement surgery is available at One Ashford Hospital in Kent and One Hatfield Hospital in Hertfordshire.
You can use your private medical insurance or pay for your Elbow Replacement Surgery treatment. We offer competitive, fixed price packages as well as the ability to spread your cost with the option of 0% finance. If you are using your health insurance please do contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.
Why One Healthcare
- Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
- Fast access to diagnostics including MRI, Xray and Ultrasound
- Private, spacious, en-suite rooms
- Specialist Physiotherapy and nursing teams
- Little or no waiting time
- ‘Ultra clean air’ theatres
- Freshly prepared food
- Calm, dignified experience
Mr Jai Relwani
Consultant Orthopaedic Surgeon; Clinical Lead - Shoulder & Elbow Service
One Ashford Hospital
Mr Rajeev Sharma
Consultant Orthopaedic Surgeon - Upper Limb Surgery (Shoulder, Elbow, Wrist and Hand)
One Hatfield Hospital