Elbow Replacment

An elbow replacement can come in a variety of different designs.

In early, but significantly symptomatic, disease a lateral elbow replacement can be undertaken. This involves replacing only the capitellum and the radial head. However, the decision to undertake such an operation is still a significant one however it carries with it none of the significant functional restrictions that an elbow replacement has as it is more robust and doesn’t have the same risks of loosening that a conventional total elbow replacement has. It is therefore useful in the younger patient with not suchadvanced disease.

In more advanced cases of degenerative disease, a total elbow replacement will be necessary. If such cases, the elbow replacement acts in such a way that it is described as a ‘sloppy hinge’ such that, following the operation, elbow flexion and forearm rotation can be achieved in a pain free manner after the operation.

The choice of implant will be made based on the nature of your disease and on what implant will give you the best clinical result.

Information for patients / operative Information

Risks and complications

• Infection
• Bleeding
• Nerve injury
• Continued discomfort
• Residual or recurrentelbow stiffness
• Loosening
• Need for later revision

Before admission

• Please bring any X-rays or scans with you to the hospital. This will usually be on a CD disc. These will not be needed if it was Mr. Falworth who organised the investigations.
• No food for 6 hours, or drink for 4 hours, prior to surgery.
• Please avoid smoking for 12 hours prior to surgery

In Hospital

• An elbow replacement usually requires a hospital stay ranging between 2-4 days.
• A single incision measuring approximately 20cm is made over the back of your elbow.
• The wound is repaired with dissolving buried sutures and Steri-strips
• Splash proof dressings will be applied but the wound should remain dry for 10 days.
• For the first 24 hrs after your operation you may be placed with your arm in extension so as to rest the operative wound. You will then be placed in a sling.
• Prior to your discharge from hospital, a physiotherapist will demonstrate some simple exercises as part of your rehabilitation protocol. These exercises should be undertaken when you’re at home and will help your shoulder recover from the surgery before your outpatient physiotherapy commences.

What to Expect

• Swelling; immediately after an elbow replacement there can be quite a lot of swelling around the elbow and hand. This settles after approximately 48 hours but can be speeded up if gentle finger movements are undertaken soon after the operation. Ice, or alternative cold therapy compress, can be helpful in minimising swelling and inflammation.
• Pain; an Interscalene Block is often used to reduce immediate post-operative pain. If any discomfort arises once the block has worn off, simple oral analgesics can be taken to manage this. These will be provided to you upon discharge.
• Bleeding; there may be some oozing through the bandages but this should settle soon after the operation.

Post-operative care

• A sling will be provided to help rest the elbow during the day. This should be worn for six weeks to allow for the muscle repairs undertaken during the surgery to heal. At night, you will sometimes exchange the sling for a removable night extension splint. This is aimed at trying to encourage both flexion and full extension soon after the operation. Mr Falworth will decide if this is necessary at the time of surgery.
• The wound should be kept dry for 10 days.
• At ten days the dressing and paper Steristrips can be gently removed. If the wound is ‘dry’ then it is all right to wash the wound, if not consult Mr. Falworth.
• The most important part of your post-operative care is to start an early exercise programme, which the ward physiotherapist will have commenced prior to discharge from hospital. This will maximise the benefit of your operation and will continue as an out-patient.

Post-operative appointments

• You will be reviewed in clinic approximately 3 weeks following your surgery.

Estimated return to functional activities