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Spire Manchester Hospital




Elbow Replacement


Why do I need an elbow replacement?
 
You will need surgery on your elbow because of arthritis to the joint. This arthritis has occurred as a result of either an inflammatory condition such as rheumatoid arthritis or osteoarthritis.
 
The purpose of the surgery is to reduce the amount of pain felt at the elbow and to maintain or sometimes improve the range of movement of the joint.
 
What does the operation involve?
 
An incision is made over the back of the elbow. The muscle on the back of the upper arm (the triceps) is released and access to the elbow obtained. The joint is replaced by removing the worn bony joint and inserting a metal component into the humerus (the bone of the upper
arm) and a plastic and metal component into the ulna (one of the forearm bones). During surgery the nerves around the elbow are protected.
 
At the end of the operation the triceps muscle is repaired and the wound is closed with a dissolving stitch. A padded bandage and sling is applied to the elbow in order to allow the soft tissues to rest.
 
What happens after the operation?
 
Following surgery you will be encouraged to move your fingers; your wrist and the elbow can be moved within the bandage. You will be discharged once you are comfortable, usually 1-3 days after surgery.
 
Follow-up is arranged 7-10 days after discharge when physiotherapy to the elbow will commence. This involves mobilising exercises to the elbow. The triceps muscle is protected until this has fully healed and you should not use crutches, sticks, frames, or use the arm for pushing yourself up when sitting until 6 weeks following surgery. You may need to see the occupational therapist for equipment to help you with everyday life, e.g. high chairs, raised toilet seat, stair rails.
 
A good range of movement should be achieved by 6-8 weeks allowing you to reach your face and extend your arm to perform all activities of daily living. Depending on the preoperative range of movement there may be certain limitations to the function of the arm. There is a 90%
likelihood that the replaced joint will last for 10 years or longer. 

You should refrain from activities involving sudden impact to the elbow or jarring. It is possible to return to hobbies such as light gardening, bowling etc but strenuous activities should be avoided.
 
Can the operation do me any harm?
 
Anaesthetic - rarely problems can occur related to your general health. The potential problems should be picked up at the pre- assessment clinic. Your anaesthetist will be able to discuss this further with you. 

Wound leakage or bleeding - this is often seen over the first 2-3 days but will normally have settled by the time the bandage is removed. If leakage occurs following discharge from hospital you must
contact the surgical department immediately.
 
Infection - infection can occur in any operation. Antibiotic treatment is given before and after surgery in order to reduce the risk of infection. Infections are rare but are more likely in patients treated with specific drugs for rheumatoid arthritis. If infection is suspected (swelling,
redness, leakage from the wound and/or high temperature) antibiotic treatment is commenced and further surgery to the elbow may be required. Very rarely it may be necessary to remove the elbow
implant in order to overcome the infection.
 
Nerve damage - the nerve going to the ring and little finger may be damaged during surgery. Often patients feel a tingling sensation in the ring and little finger after surgery, which is normally temporary. It is very rare that permanent damage to the nerve occurs, but if so this may affect the function of the hand.
 
Dislocations - dislocation of the joint may occur rarely. This is treated by relocating the elbow followed by resting the arm in a brace for 4-6 weeks, but occasionally further surgery is required.
 
Loosening or wear the components used in the surgery may loosen or wear over time, but this is rare within 10 years of surgery. Fractures of the bone around the components may be seen in patients with poor quality bone prior to surgery, for example in rheumatoid arthritis. As a result of this revision surgery with replacement of the components may be required.


The Manchester Orthopaedic Group has three hand and wrist surgeons. Steve Royle , Jochen Fischer and Mohammed Waseem are established consultants. They are able to offer a range of treatments for various conditions from carpal tunnel syndrome to wrist arthritis.

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