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Elbow Replacement
Overview
Elbow replacement surgery is a complicated procedure partly because the elbow has several moving parts that balance each other with great precision to control the movements of your forearm.
Your elbow can be damaged by problems ranging from rheumatoid arthritis to traumatic fractures. In some cases, the damage can be surgically repaired. But if the damage is extensive, your doctor might recommend elbow replacement surgery. Pain is the most common reason people choose to have elbow replacement surgery.
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What Is Elbow Replacement Surgery?
If a disease such as rheumatoid arthritis or an injury has harmed your elbow, your doctor may recommend surgery to replace the joint, so you have less pain and can move better. During elbow replacement, a surgeon replaces your elbow with an artificial joint made from two implants that attach to the bones in your arm. A metal and plastic hinge joins the implants together. The procedure is similar to hip and knee replacements.
Types of elbow replacement
In some cases, you may need a replacement of just one portion of the joint. For example, if only the head of one of your forearm bones (radius) is damaged, it can be replaced with an artificial head.
If the entire joint needs to be replaced, the ends of the bones that come together in the elbow will be removed. Bones are hard tubes that contain a soft center. The long, slender ends of the artificial joint are inserted into the softer central part of the bones.
There are two main types of prosthetic devices available:
- Linked. This type of prosthesis acts somewhat like a loose hinge because all the parts of the replacement joint are connected. This provides good joint stability, but the stresses of movement can sometimes result in the prosthesis working itself loose from where it’s inserted into the arm bones.
- Unlinked. This type of device comes in two separate pieces that aren’t connected to each other. This design depends on the surrounding ligaments to help hold the joint together, which can make it more prone to dislocation.
What Are the Risks?
The most common complications are:
- Infection
- Injury to nerves and blood vessels
- Allergic reaction to the artificial joint
- Broken bone
- Stiffness or instability of the joint
- Loosening or wearing of the artificial parts
- Weakness or failure in the tendons of your arm
- Pain
There are risks because of the anesthesia, such as an allergic reaction to those medicines and breathing problems. As with any surgery, bleeding and blood clots are possible too.
What to Do Before the Operation?
Dr. Gauresh Palekar or your doctor will ask you about your medical history. Tell them about any conditions you have, including allergies. Also, let your doctor know if you drink alcohol and what medicines you take. She also needs to know about any vitamins, supplements, or herbal products you use. If you smoke, you should stop before your surgery.
How You Prepare
Tests Before The Surgery (Pre-operation Work-up)
Once you have decided to get operated we should do some blood tests to prepare your body for this surgery. This involves a check-up by an anaesthetist and a physiotherapist. These visits are geared to intimate you about the procedure followed during surgery and prepare you for a faster recovery. We will need to get some tests done. They are:
- Complete Blood Count
- ESR – Erythrocyte Sedimentation Rate
- CRP – C Reactive Protein
- Blood Sugar – Fasting
- LFT – Liver function Test including S. Proteins and enzymes.
- S. Creatinine
- BUN
- S. Electrolytes
- HIV
- HbsAg
- HCV
- Blood Grouping
- Bleeding / Clotting time
- Prothrombin time / Index
- Urine – Routine / Microscopy
- Urine – Culture sensitivity
- ECG
- 2D Echo
- Xrays – Chest PA view – Both Knees – AP standing and lateral
- Special tests: Additional tests
- Blood sugar PP (2 hrs. After Lunch) – Diabetes
- Pulmonary function tests – Asthma
Admission to the Hospital
Click Here To Download the Instructions in PDF Format.
- Do not eat or drink anything from ________ time onward to ________ a date prior to surgery. This includes Water, tea coffee, etc. Do not drink alcohol or smoke 24 hrs before the surgery.
- All Pain medications like Voveran and Brufen should ideally be stopped 7 days before the Surgery. Blood Thinning Medicines like Aspirin (2 Days) or Clopedogrel need to be stopped 7 days before the surgery.
- Please removes all Jewellery before getting admitted to the hospital.
- Please get admitted with a Toothbrush, Tooth Paste, and Dettol/ Savlon Soap. Towel, Glasses, Hearing aids, Reading material, and Dentures.
- Please Get a list of all the medicines that you are taking daily and the time. Also, Get 1 strip of each medicine you are taking.
- Please get a list of the 2 closest relations, their relationship with you, and their Home/Office and mobile contact number and hand it to the sister to put on Indoor Hospital Paper.
- Please bring along all your blood tests and reports and CT/MRI films.
- Please get your Walker / Crutches if needed.
What to Expect?
Elbow replacement surgery takes about 2 hours. You’ll get anesthesia, so you won’t be “awake” for it. You’ll need to stay in the hospital for up to 4 days. After the operation, you’ll have stitches and a bandage on your new elbow. You may also need to keep your arm in a splint to keep it stable while it heals. Because elbow replacement involves cutting skin, tendons, and bone, you’ll need strong pain medications after surgery.
You’ll also take pain meds for 1 to 2 weeks after you go home from the hospital. It will take time to get used to your new elbow. For instance, you won’t be able to lift anything heavier than a cup of coffee for 6 weeks after surgery. It’s a good idea to line up help ahead of time.
Understanding Limitations After Elbow Replacement
That said, elbow replacement isn’t for everyone. “The main limitation of elbow replacement surgery is the permanent lifting restriction of not more than seven pounds,” says Dr. Maschke. In addition, the implants aren’t likely to hold up for the several decades that would be necessary if used in a younger adult. For these reasons, elbow replacement surgery generally is reserved for older adults who don’t need to lift heavy items.