Total elbow replacement is carried out when the elbow is no longer functioning properly. This may be for a variety of reasons – inflammatory arthritis, complex fractures, tumour or osteoarthritis.
The procedure is done under general anesthesia (asleep) in addition to a nerve block for pain relief. You are positioned on your side and a tourniquet is placed around the top of the arm to prevent bleeding during the surgery. The incision/cut is made on the back of the elbow and once the new elbow has been cemented in place, the skin is closed. A bulky bandage and a simple sling is applied to enable gentle but early range of movement.
Unless instructed otherwise, you can bend your elbow to bring your hand closer to your mouth and let gravity straighten your elbow. YOU MUST NOT push up out of a chair or shove anything using your arm for 6 weeks. For the rest of your life you should not be lifting objects heavier than 1.5kg for repetitive tasks. When lifting weights, damage to your elbow can be prevented by keeping the elbow alongside your body.
The main complications are infection and wound problems. If this occurs and is caught early, the prosthesis can be saved by further surgery to wash the elbow out and antibiotics through a drip. If an infection is caught late, it is usually necessary to remove the elbow replacement to eradicate the infection before a new replacement can be implanted. Nerve injury is very rare and most commonly injured temporarily. Permanent nerve injury is more common in revision surgery or following infection.
Elbow replacements results are very varied. 90% will work well for a period of around 10 years; some will last 5 and others 20! Loosening of the prosthesis is the most common long-term problem and this can cause fracture of the bones around the elbow. In these cases a more complex revision to implant a new elbow replacement may be needed.