Elbow Replacement
Elbow replacement surgery (elbow arthroplasty) is surgery to replace all or some of your elbow joint. It’s less common than other types of joint replacements. It can give you long-lasting relief from severe pain and stiffness that make it hard to move or use your arm.
Elbow replacement is surgery to replace your elbow joint. It’s a type of arthroplasty (joint replacement).
A surgeon will remove damaged sections of your natural elbow joint and replace them with an artificial joint (a prosthesis) made of metal and plastic.
There are a few types of elbow replacement surgeries. Total vs. partial replacement is how much of your elbow joint needs replacing. Linked and unliked elbow replacements are the two techniques surgeons use to insert the prosthetics.
Your surgeon will recommend either a total or partial elbow replacement:
- Total elbow replacement: Total elbow replacement is the most common type of elbow replacement. Surgeons sometimes call it total elbow arthroplasty. Your surgeon will replace damaged parts of your upper arm bone (humerus) and the bones in your forearm (the ulna and radius).
- Partial elbow replacement: A partial elbow replacement is just what it sounds like. Your surgeon will only replace some areas of your elbow joint. Partial elbow replacements are much less common. Surgeons usually only do partial replacements in people who’ve experienced an injury or trauma.
Your surgeon will perform a linked or unlinked elbow replacement:
- Linked: Your surgeon will insert metal stems into your humerus and ulna to support the prosthetic joint. Linked replacements are much more common.
- Unlinked: Your surgeon will connect the prosthetic joint to your existing natural ligaments and connective tissue. They’re less common because it’s rare for people’s ligaments to be strong enough to support the prosthesis. Usually, if your elbow is damaged or worn enough to need an arthroplasty, your ligaments are also affected.
A healthcare provider might recommend elbow replacement if you have severe symptoms that don’t get better after trying nonsurgical treatments, including:
- Joint pain.
- Stiffness.
- Limited mobility (trouble moving your elbow).
- Swelling.
Arthritis is the most common condition that causes people to need elbow replacement surgery, including:
- Osteoarthritis.
- Rheumatoid arthritis.
- Post-traumatic arthritis (arthritis that develops years after an elbow fracture or dislocation).
It’s rare, but a healthcare provider might suggest an elbow replacement if you’ve experienced a severe elbow fracture (broken elbow).
Your healthcare provider and surgeon will tell you what you need to do to get ready for surgery. In general, you’ll need:
- A physical exam to make sure you’re healthy enough for surgery.
- Blood tests.
- An electrocardiogram (EKG) to check your heart health.
- A dental exam to reduce your risk of developing an infection after surgery.
- Imaging tests, including an elbow X-ray and, possibly, an MRI (magnetic resonance imaging) or CT scan (computed tomography scan).
Tell your provider and surgeon which medications and over-the-counter (OTC) supplements you take. You may have to stop taking some medications or supplements before your surgery.
You won’t be able to use or move your elbow for several weeks after elbow replacement surgery. You might want to plan ahead and move essential items you use often to lower shelves or a temporary, easy-to-reach location in your home.
Your surgeon will tell you when you should stop eating and drinking the day before your surgery. Most people need to avoid eating and drinking for 12 hours before their surgery.
The day of your surgery you’ll receive anesthesia to numb your arm and make sure you don’t feel any pain. An anesthesiologist will also give you general anesthesia to put you to sleep during your surgery.
During an elbow replacement your surgeon will:
- Make an incision (cut) in your skin on the back of your arm near your elbow.
- Remove damaged cartilage and bone from inside your joint.
- Reshape the ends of your humerus and ulna.
- Insert the prosthetic joint.
Elbow replacement surgery usually takes two hours from start to finish.
After surgery, you’ll be moved to a recovery room. Your surgery team will keep an eye on you for a few hours to make sure you wake up from the anesthesia without complications. They’ll also monitor your vital signs and pain level.
Elbow replacements are usually inpatient procedures, which means you’ll have to spend a day or two in the hospital.
Elbow arthroplasty is a safe, effective procedure that helps people regain their mobility and relieves long-term pain. Most people who have an elbow replacement have reduced pain, increased ability to move and use their arm, and an improved quality of life.
Elbow replacements can last a long time. Studies have found that around 80% of people who have elbow replacement surgery live with their prosthetic for at least 10 years. Linked elbow replacements are even more successful — around 90% of people still have them 10 years later.
Complications can happen after any surgery. Around 15% of people who get an elbow replacement need another surgery on that elbow in the future. The younger you are when you have an elbow replacement, the more likely you are to need a reoperation.
The most common elbow replacement complications include:
- Fractures around the implant.
- Infection inside your elbow or at your surgery site.
- Nerve damage.
- Blood vessel damage.
- Problems with the prosthetic implant, including the device wearing down too soon or loosening.
- Scar tissue inside your elbow that limits how far you can move your elbow (your range of motion).
Certain health conditions can make recovery from an elbow replacement more difficult. Talk to your surgeon about your health history. Tell them if you have:
- Hemophilia.
- Diabetes.
- Osteoporosis.
- Other autoimmune diseases (like lupus).
Your surgeon will tell you what you can expect after your surgery and how you can reduce your chances of experiencing complications.
Elbow replacement lifting restrictions
Unlike other types of joint replacements, prosthetic elbows can be very fragile. That’s because the bones in your arms are smaller and thinner than the ones around other joints that are commonly replaced.
Most people who have an elbow replacement can’t lift heavy weights. You might also have to avoid contact sports and intense physical activities that put stress on your elbow.
You may not be able to lift more than 5 pounds with that arm for the rest of your life. This is to prevent the prosthetic from loosening or breaking. You may be able to lift more weight if you have a partial replacement. Your surgeon will tell you what to expect.
It takes around a year to recover after elbow replacement surgery.
You won’t be able to move or use your elbow for at least a few weeks right after surgery. Your surgeon might put your elbow in a splint or brace to hold it in place and take pressure off it.
You’ll start physical therapy a few months after surgery (usually around 12 weeks). A physical therapist will give you exercises that strengthen your arm muscles and help you regain your range of motion.
Even after you’re fully recovered, you may have a weight limit with that elbow for the rest of your life.
After surgery, you’ll feel pain, especially in the first few weeks of your recovery. You’ll feel pain from the surgery itself and pain as your body begins to heal.
Your surgeon will suggest a combination of prescription pain medication, over-the-counter (OTC) NSAIDs (if it’s safe for you to take them) and acetaminophen to relieve your pain. Your surgeon will tell you how much of each kind of medication you can take each day or in a certain amount of time.
Talk to your surgeon if you feel like you’re experiencing too much pain or if you’re worried about any complications from taking pain medication.
When should I call my healthcare provider?
Call your surgeon or healthcare provider right away if you experience any of the following symptoms:
- Chest pain.
- Shortness of breath (dyspnea).
- Fever higher than 101 degrees Fahrenheit (39 degrees Celsius).
- Bleeding.
- Signs of infection at your surgery site — including leaking, swelling, discoloration, odor or a feeling of warmth.
- Severe pain that doesn’t get better after you take pain medication.
References
- American Academy of Orthopaedic Surgeons. Total Elbow Replacement (https://orthoinfo.aaos.org/en/treatment/total-elbow-replacement/). Last reviewed 4/2022. Accessed 11/1/2024.
- Arthritis Foundation. Elbow Surgery Options (https://www.arthritis.org/health-wellness/treatment/joint-surgery/preplanning/elbow-surgery-options). Accessed 11/1/2024.
- Evans JP, Evans JT, Mohammad HR, et al. How long does an elbow replacement last? A systematic review and meta-analysis of case-series and national registry reports with more than 10 years of follow-up (https://pubmed.ncbi.nlm.nih.gov/35642497/). Acta Orthop. 2022;93:495-502. Published 2022 May 31. Accessed 11/1/2024.
- National Library of Medicine (U.S.). Elbow replacement (https://medlineplus.gov/ency/article/007258.htm). Last reviewed 9/20/2022. Accessed 11/1/2024.
- Pooley J. Total elbow replacement – patient selection and perspectives (https://pubmed.ncbi.nlm.nih.gov/31040724/). Orthop Res Rev. 2019 Jan 25;11:23-40. Accessed 11/1/2024.
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