In total elbow replacement surgery, the damaged parts of the bones that grind together are replaced with metal and plastic implants, your surgeon will remove the damaged portions of the ulna and humerus. The replacement parts will then be fixed into place.
The replacement parts consist of two long metal stems that fit down into the shafts of the bones. The two stems are then connected at the ends by a metal pin which fits into a plastic bearing. This bearing will allow you to bend your elbow without allowing the arthritic bones to contact each other.
HOW WILL I KNOW IF I SHOULD HAVE ELBOW REPLACEMENT?
Your orthopedic surgeon will perform a very thorough examination of the elbow. This will include a check of the muscles and tendons to determine how much strength and range of movement you have.
Your surgeon will also ask you many questions to determine your medical history. For example, you will be asked to describe your pain and how your have treated this pain in the past. You will also be asked to about other joint problems, and about injuries, infections, and other disorders you have experienced in your life that may have affected your elbow. Your surgeon will also want to know that medications you are taking.
Finally, your surgeon will take x-rays, which will be used to further assess the condition of your elbow joint. If you decide on total elbow replacement surgery, these images will also be used to help your surgeon select the best type and size of artificial elbow.
Based on this examination, you surgeon will determine whether you are a candidate for total elbow replacement. Although widely practiced, total elbow replacement is a major surgical procedure and should only be considered when all other treatment methods have failed. Which you and your surgeon may want to consider. These include medications or injections for pain and inflammation, physical therapy, or other types of surgery.
The final decision about whether or not to have total elbow replacement surgery will be yours, so you want to understand the risks involved. There are potential complications both during and after surgery. Generally, these include infection, blood clots, pneumonia, implant loosening, and nerve damage. Your surgeon can answer your specific questions about these risks.
WHAT TO EXPECT AFTER SURGERY
Your arm will be elevated for first 48 hours. The day after surgery, you can begin gentle elbow exercises and rehabilitation program as advised by the surgeon and physical therapist. The rehabilitation program is designed for every patient and will help you regain strength and range of motion in the elbow.
Discharge is usually on 2nd or 3rd day after surgery and suture removal at 12-14 days.
A successful total elbow replacement will relieve your pain and stiffness and allow you to resume your normal daily activities, as instructed by your doctor. Even after full recovery, there will be some restrictions, like avoiding contact sports and activities that put excess strain on your elbow. You should not push or pull forcefully with the operated elbow. You will also be instructed on the maximum weight you can lift with the operated arm. Revision total elbow replacement is not as successful as the primary elbow replacement, thus taking proper care and precautions is paramount.
COMMON INDICATIONS FOR ELBOW REPLACEMENT.
REHABILITATION IN THE HOSPITAL
Your participation in a physical therapy program is essential to the success of your surgery. Lenox hill hospital has an outstanding staff of physical therapist to assist you. The more committed and enthusiastic you are, the speedier your improvement will be.
A physical therapist will visit you on the day after surgery to instruct you in an exercise program. This program is intended to increase the range of motion and strength to your legs. In the first few days after surgery, you may benefit from taking pain medication thirty minutes prior to physical therapy session. You should discuss this with your primary nurse and/or the therapist
The physical therapist will assist you first in sitting up (dangling) at the bedside, then in the standing with the aid of walker. You may place full weight on your operated side, as tolerated.
As days go by, you will walk farther and more comfortably. Most of our patients shift to a cane with 24-72 hours of surgery. Almost all patients can climb up and down the stairs before going home.
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