Rheumatoid Arthritis Health Center

Elbow Replacement

Elbow replacement, or total elbow arthroplasty, is surgery that can reduce pain and restore mobility in people whose elbow joints have been damaged. The damage could be from a disease such as rheumatoid arthritis (RA) or from a traumatic injury.

How Elbow Replacement Is Done and Who Does It

During elbow replacement, a surgeon removes damaged tissue and parts of the two arm bones -- the humerus and the ulna -- that meet at the elbow joint. After removing tissue and bone, the surgeon replaces the elbow joint with an artificial one. The artificial joint consists of two implants that are attached to the insides of the humerus and ulna. The implants are joined together by a metal and plastic hinge. Various types of implants exist to fit joints of different sizes.

Elbow replacement is similar to hip and knee replacement. It is, though, much less common, with only a few thousand replacements done each year in the U.S.

If you're considering elbow replacement, it's best to find a surgical team led by an experienced elbow arthroplasty surgeon. There are, though, few such teams nationwide. So it's likely that you'll have to travel to another city or state to have the procedure done.

You can locate surgical teams that regularly perform elbow replacement through:

• University schools of medicine
• County medical societies
• State orthopaedic societies
• Local rheumatologists
• Professional associations such as American Shoulder and Elbow Surgeons

Why Elbow Replacement Is Done

Elbow replacement was first done to replace joints damaged by RA. Its success rate is still highest among people with arthritis who are highly motivated and in the best health. Because early mechanical failure is more likely to occur among younger, more active people, the procedure is most suited for people older than 60 years of age.

In recent years, candidates for elbow replacement have included more than just people with RA. Others who might consider it include people whose elbows have been damaged by:

• Osteoarthritis
• Joint disease
• Arthritis after injury (traumatic arthritis)
• Arthritis after previous surgery
• Acute fractures in the upper or lower arm near the elbow
• Tumors or tumor resection

Risks of Elbow Replacement Surgery

The most common complications of elbow replacement include:

• Infection
• Injury to nerves and blood vessels
• Allergic reaction to the artificial joint
• Fracture
• Stiffness or instability of the joint
• Loosening or wearing of the artificial parts
• Triceps tendon weakness or failure
• Pain
• Need for additional surgeries

The procedure also is associated with the typical risks for any anesthesia, such as allergic reaction to medicines and breathing problems. There are also the typical risks for any surgery, such as bleeding and blood clots.

What to Expect Before and After Elbow Replacement Surgery

Prior to surgery, you should stop smoking and address any existing medical problems. Any active infection must be treated before surgery.