Elbow replacement surgery, also known as elbow arthroplasty, is a surgical procedure of replacing the elbow joint with implants made of either metal or plastic. The elbow joint is made up of the distal end of the humerus and the proximal ends of the radius and the ulna. The objective of an elbow replacement surgery is to remove damaged areas of the bones making up the joint. Typically, elbow implants come in three parts; one fixed on the humerus, one on the ulna, and a hinge placed in between to provide mobility of the arm. 

Symptoms that may require elbow replacement surgery as treatment include:

• Chronic pain when mobile and at rest 
• Stiffness followed by a sensation of elbow grinding or locking 
• Visible swelling at the elbow 
• Inability to conduct daily activities or mundane tasks due to pain 

One may either have a total elbow replacement or just limit the replacement to one joint compartment. This depends on the extent of injury at the elbow joint.  Some examples of a partial elbow replacement include:

• Distal humerus replacement 
• Radius head replacement 
• Capitellar replacement 
• Trochlear replacement 

Following your orthopaedic evaluation, imaging tests such as x-rays and magnetic resonance imaging (MRI) will be conducted to confirm surgery suitability. A surgery date will then be assigned. 

Depending on the type of surgery, the procedure would involve different techniques and approaches: 

• Complete elbow replacement: all parts of the elbow joint are replaced with implants. First, damaged parts of the humerus and ulna bones are removed. The ends of the bone that meet are then replaced with metal components. Finally, metal stems are placed in the bones to fill in the vacuum that was created from the removal. 

• Partial elbow replacement: only the affected area of the elbow joint is removed. This involves replacing the joint of the affected elbow with a metal piece. 

• Linked elbow replacement: a linking cap is used to connect the metal implants of the joint; necessary when ligaments are not sufficiently healthy to hold joint pieces together. 

• Unlinked elbow replacement: a hinge is not included as an implant. Healthy ligaments will be used to hold replacement implants together. Unlinked elbow replacement is preferred in younger patients. 

• Reduces pain 
• Overcomes stiffness of the joint 
• Increased mobility 
• Effective 
• Improved quality of life

Elbow replacement surgery can be used to treat the following conditions:

• Arthritis: patients with arthritis such as osteoarthritis would benefit from elbow replacement surgery to replace degenerated bones. 
• Fractures: fractures that result in fragmentation of the bone would require an elbow replacement as the bones will not be able to be pieced together on their own. 
• Elbow tumours: although a rare occurrence, elbow replacement is utilised to prevent total amputation as a measure of salvaging the limb. 
• Elbow instability: traumatic injuries that cause elbow instability and loss of function can be treated with elbow replacement

At a success rate of 85%, one can expect alleviation of pain sustained pre-surgery. Most patients also reportedly have improved range of motion and newfound strength. Following this success, quality of life is dramatically improved, with benefits extending to psychological relief. It would take approximately 3 months to recover and continue one’s daily routine. Where strengthening of the elbow and participation in other activities such as low-demand sports is concerned, recovery could take up to one year. 

Discipline and dedication towards physiotherapy would help in speeding up recovery. Diets and post-surgical habits could also impact your healing rate. With positive post-surgical care and collaborative work with your orthopaedist, a positive outcome can be anticipated. 

Your orthopaedist can give you a better idea of what to expect based on your individual needs and circumstances. 

Over 80% of all elbow replacements and over 90% of linked elbow replacements can last more than 10 years. After the set period, replacements of implants may be necessary. Despite 10 years being seemingly long for many, this is not the case for someone who’s in their childhood, teens, or young adulthood. Thus, the apprehension for orthopaedists to conduct elbow replacement surgeries in a younger demographic. However, if deemed completely necessary, this surgery would be performed nevertheless with future plans debriefed during consultation.

Excess stress on elbow joints through demanding activities will reduce the lifespan of your implant. Habits such as smoking will also impede the recovery rate. To attain complete recovery, one will need to attend physiotherapy sessions and appropriately manage medications such as painkillers, antibiotics and blood thinners. The frequency of physiotherapy sessions will vary according to your condition. 

Your orthopaedist will be able to provide you with a bespoke treatment plan, tailored to your needs and requirements.