Total elbow replacement may seem drastic, but it can be life-changing for those who need it. In some cases, replacing the entire elbow joint is the only effective treatment. This surgery relieves painful conditions that prevent people from performing everyday activities.

Though elbow replacement is a complex surgery – and nowhere near as common as knee or hip replacement surgery – it’s becoming more and more common as technology and surgical techniques advance. However, orthopedic surgeons who specialize in elbow procedures still consider total elbow replacement as an end-of-the-line measure.

Elbow Surgery: Common Causes & Conditions

Each injury is unique; however, several common conditions often require elbow replacement surgery. For instance, severe fractures that cannot heal properly may need surgical intervention. Additionally, chronic arthritis can cause significant joint damage, leading to the necessity of replacement. Trauma from accidents or injuries might also make surgery essential. Finally, persistent pain or loss of function can force patients to consider surgery as a long-term solution.

Rheumatoid Arthritis, Osteoarthritis & Post-traumatic Arthritis

The most common inflammatory arthritis, rheumatoid arthritis is an autoimmune disorder that damages the lining of joints and causes chronic, painful swelling that can result in cartilage loss, joint pain and joint stiffness.

Osteoarthritis is the most common type of arthritis – particularly in older adults. Considered a “wear and tear” disease that usually affects people over 50, osteoarthritis occurs when the cartilage in joints wears away, allowing bones to painfully rub against each other.

Post-traumatic arthritis affects approximately 5.6 million people in the United States. A very common form of osteoarthritis, post-traumatic arthritis can affect any joint that has suffered a past physical injury or trauma.

Elbow Instability

Elbow instability and dislocations commonly result from joint or ligament injuries. When ligaments are damaged, the elbow joint loses stability. This damage weakens the support structures, leading to potential dislocation. In most cases, the ligaments are unable to properly hold the elbow joint together. As a result, the joint can easily shift out of place. Consequently, patients experience pain and limited movement. Therefore, addressing ligament damage early is crucial for restoring elbow stability and function.

Severe Fractures

If an elbow is shattered, there is a severe fracture in one or both of the bones that make up the elbow or if an old fracture does not heal correctly, a complete elbow joint replacement may be necessary.

Types of Elbow Replacement Surgeries

For some elbow injuries and conditions, you may not need a full joint replacement – instead, you may need to replace only one section of your elbow joint. For instance, if the head of your radius (forearm) needs to be replaced but the rest of your elbow joint is healthy, an artificial head can save you from a full elbow joint replacement.

For those who require a total elbow replacement, there are two common types of prosthetic joints: linked and unlinked.

Linked Elbow Prosthetic Joints

Linked elbow prosthetic joints allow for improved joint stability, as the linked nature of the prosthetic acts as a hinge with all of the elbow joint parts connected.

Unlinked Elbow Prosthetic Joints

Unlinked elbow prosthetic joints are made up of two separate pieces that require the surrounding ligaments to help hold the joint together.

Both linked and unlinked elbow prosthetics have pros and cons. During your appointment, your orthopedic elbow specialist should consult with you about all of your options and discuss a treatment plan that is best for you and your injury.

Total Elbow Replacement Surgery

The Academy of Orthopaedic Surgeons describes the elbow joint surgical procedure as such:

“To reach the elbow joint, your surgeon will make an incision (cut), usually at the back of the elbow. After making the incision, your surgeon will gently move muscles aside to get access to the bone. After removing scar tissue and spurs around the joint, your surgeon will prepare the humerus to fit the metallic piece that will replace that side of the joint. The same preparation is done for the ulna.

The replacement stems are placed into the humerus and ulna bones, and kept in place with a bone cement. The two stems are connected by a hinge pin. After the wound is closed, a padded dressing is then placed to protect the incision while it heals.”

While this gives a good general picture of common surgical procedures for a total elbow joint replacement, your actual procedure may vary based on your injury, condition, surgeon or possible complications. Be sure to ask your elbow surgeon to walk you through his or her plan for your surgery to get a better understanding of your surgery.

Possible Elbow Surgery Complications

As with any surgical procedure, elbow replacement surgery comes with potential complications. Your orthopedic surgeon will go over the following possible complications with you before your elbow surgery.

Infection & Wound Healing

Infections and improperly healed wounds are possible complications with any surgery, including elbow joint replacements. Infections can develop around the artificial joint within the elbow or at the site of the incision. Additionally, infections of the prosthetic joint can occur years later, as any bodily infection can spread to the artificial joint.

While minor infections can be easily treated, talk to your orthopedic surgeon about preventative measures and medications.

Nerve Injury

Rare but possible, nerves in and around your elbow can be damaged during surgery. Most surgical nerve injuries will improve on their own with time.

Elbow Prosthetic Complications

Unfortunately, artificial joints and their components may wear down over time. While procedures, materials and techniques improve every day, implants can deteriorate, loosen or break. If this happens, additional surgery may be necessary.

If you’re experiencing severe elbow pain or paralysis, you should consult a local orthopedic surgeon to discuss your treatment options. If you have any questions, concerns or comments, please feel free to contact us. We’re happy to help in any way we are able.