Elbow replacement

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

Prosthetics

A prosthesis is a device designed to replace a missing part of the body or to make a part of the body work better. Diseased or missing eyes, arms, h...

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Description

The elbow joint connects three bones:

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

The artificial elbow joint has two or three 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.

The surgery is done in the following way:

• You'll receive general anesthesia . This means you'll be asleep and unable to feel pain. Or you'll receive regional anesthesia ( spinal and epidural ) to numb your arm.

  General anesthesia

  General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive the...

   

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  Spinal and epidural

  Spinal and epidural anesthesia are medicines that numb parts of your body to block pain. They are given through shots in or around the spine....

   

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• 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 arm bones.
• The ends of the artificial joint are usually glued in place into each bone. They can be connected with a hinge.
• The tissue around the new joint 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:

• Osteoarthritis

  Osteoarthritis

  Osteoarthritis (OA) is the most common joint disorder. It is due to aging and wear and tear on a joint.

  

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• Poor outcome from past elbow surgery
• Rheumatoid arthritis

  Rheumatoid arthritis

  Rheumatoid arthritis (RA) is a long-term disease. It leads to inflammation of the joints and surrounding tissues. It can also affect other organs....

  

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• Badly broken bone in the upper or lower arm near the elbow

  Broken bone

  If more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures...

  

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• Badly damaged or torn tissues in the elbow
• Tumor in or around the elbow

  Tumor

  A tumor is an abnormal growth of body tissue. Tumors can be cancerous (malignant) or noncancerous (benign).

   

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• Stiff elbow

Risks

Risks of anesthesia and surgery in general include:

• Reactions to medicines, breathing problems
• Bleeding, blood clots, infection

Risks of this procedure include:

• Blood vessel damage during surgery
• Bone break during surgery
• Dislocation of the artificial joint
• Loosening of the artificial joint over time
• Nerve damage during surgery

Before the Procedure

Tell your surgeon 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 surgeon 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 likely ask you to see the doctor who treats you for these conditions.

  Diabetes

  Diabetes is a chronic disease in which the body cannot regulate the amount of sugar in the blood.

  

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• Tell your surgeon 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 provider for help. Smoking can slow wound healing.
• Tell your surgeon if you develop a cold, flu, fever, herpes breakout, or other illness before your surgery. The surgery may need to be postponed.

On the day of your surgery:

• Follow instructions about not drinking or eating anything before the procedure.
• Take the medicines your surgeon 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. After you go home, follow instructions on how to care for your wound and elbow.

Follow instructions

Total elbow arthroplasty - discharge; Endoprosthetic elbow replacement - discharge

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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 surgeon 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.