What Is Elbow Replacement Surgery? One Patient’s Story

You’ve probably heard about knee and hip replacement. They are two of the most common orthopaedic surgeries in the country and have a high success rate. Elbow arthroplasty, or elbow replacement, is another form of joint replacement surgery that is not nearly as common but is just as effective. 

Each year, hundreds of Americans elect to replace their elbow joints. Nina is one of these patients. She underwent her surgery with Michael D. Riggenbach, M.D., a board-certified orthopaedic surgeon at the Orlando Orthopaedic Center. Nina M. says, “It’s not a very common surgery. Now I have a prosthetic elbow and it’s been great. My elbow is working fine.”

This is Nina’s journey to health and improved mobility.

What Is Elbow Replacement Surgery?

Total elbow arthroplasty is a surgical procedure that replaces the hinge joint in the elbow with a prosthetic. The surgery completely removes the damaged elbow joint and inserts a new hinge made of metal and plastic that matches the contours of the patient’s body. 

The elbow is a complex joint located where the humerus bone of the upper arm connects with the bones of the lower arm (the ulna and radius). These bones are cushioned by articular cartilage, which keeps them from rubbing together while in motion and allows us to move freely. Smooth tissue called the synovial membrane also creates a fluid to help lubricate the joint. Ligaments, muscles, and tendons, hold the entire structure together. During a total elbow arthroplasty, the supporting structures are carefully moved aside so the doctor can remove the joint and replace it with a prosthetic.

When performing the procedure, the doctor will follow these steps: 

  • Make an incision at the back of the arm to access the joint
  • Carefully move aside the muscles and ligaments 
  • Remove the scar tissue and damaged joint
  • Prepare the remaining bones for the prosthetic
  • Use bone cement, screws, or pins, to insert and secure the prosthetic
  • Close and dress the incision

The benefits of elbow replacement are the same as replacing a knee or hip, including improved mobility and relief from pain.

Why Would I Need an Elbow Replacement?

Elbow replacements were initially developed to combat the painful effects of rheumatoid arthritis. Rheumatoid arthritis affects a person’s joints and the inflammation can wear away the tissues, causing inflammation and pain. 

Today, however, doctors are using elbow replacement more frequently to repair damage caused by falling and breaking the delicate bones of the elbow. That is exactly what happened to Nina. She says, “I broke my elbow in October 2019 when I tripped in front of a supermarket and suffered a triple fracture.” Elbow replacement was the best option to repair the damage and restore mobility to her arm. 

The research shows that older adults who experience severe fractures often do better with an elbow replacement than with the traditional plates and screws used to repair a broken bone. Older bones are often more fragile and the bone quality may not be good enough to hold the joint together. If the elbow break is severe, as in Nina’s case, starting with a fresh prosthetic joint may be the best option.

A few other conditions can also be remedied with an elbow replacement. These can include:

  • Degenerative joint disease (caused by osteoarthritis) 
  • Joint instability (underlying ligaments fail to function, causing painful dislocation) 
  • Post-traumatic arthritis that flares up after an injury

In Nina’s case, the elbow fracture was so severe that Dr. Riggenbach recommended replacing the entire joint. Nina says, “I couldn’t grip. I couldn’t hold my hand closed. I couldn’t stretch my arm out.” Three months later, Nina underwent elbow replacement surgery. What was her recovery like?

What Is Recovery Like After Elbow Replacement Surgery?

For elbow replacement patients like Nina, the healing process begins at home. While every patient is different, recovery takes approximately six weeks or so before you can put weight or resistance against the hand and arm. It’s important to follow your doctor’s instructions during this time. 

After surgery, you will receive antibiotics to prevent infection as well as medications to manage pain. It’s natural to feel some pain during recovery, but your surgical team will work hard to keep you comfortable as you gradually regain the use of your elbow.

During recovery, your doctor will carefully monitor your rehabilitation to ensure a quick recovery. You will also work closely with a physical therapy team to improve your mobility. The process will include:

  • Hand and wrist exercises designed to reduce swelling and stiffness
  • Mobility and range-of-motion exercises to keep the joint moving

During this time your doctor will monitor your recovery and make changes as necessary to facilitate healing. Ultimately, their goal is to help you resume your active lifestyle without the pain and mobility issues you once experienced.

Am I a Candidate for Elbow Replacement?

Elbow replacement surgery isn’t for everyone. The biggest limitation after surgery is a permanent weight limit on how much you are allowed to lift. For this reason, the surgery is mostly performed on older patients. However, the process of joint replacement and the design of prosthetic implants continues to improve, making this a promising surgery for the future, without the same limitations.

Nina is just one of many Orlando Orthopaedic Center success stories. She says, “It healed very quickly. I’ve had occupational therapy. I have my grip back. I have full movement. It’s much easier now. I am an Orlando Orthopaedic Center frequent flyer because [I have had] three surgeries with Dr. Riggenbach. He really is great.”

If you’re experiencing elbow pain or another joint mobility issue, don’t hesitate to contact the caring team at Orlando Orthopaedic Center. We’re here to get you back to health.