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Elbow Replacement
Surgery

Experience the finest care for severe elbow joint damage at Sri Balaji Hospital in Chennai. Schedule an appointment for our expert elbow replacement surgery today.
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A close-up shot of a patient holding his elbow in pain.

Natural Anatomy of Elbow

The elbow is a pivotal articulation composed of three essential bones: the humerus, ulna, and radius. These bone extremities are sheathed in cartilage, a flexible tissue that facilitates smooth joint movement and acts as a shock absorber. Ligaments serve as the connecting elements that conjoin these bones, thereby forming the joint capsule. This joint capsule, in turn, is filled with synovial fluid, which envelops and lubricates the elbow, ensuring its optimal functionality.

About Elbow Replacement Surgery

Elbow replacement surgery is a procedure designed to address severely damaged joint surfaces within the elbow joint.

The destructive damage to the elbow joint (caused by age-related conditions or diseases of the elbow) resulting in elbow replacement surgery is less common when compared to knee, hip and shoulder replacement surgeries.

Types of Elbow Replacement Surgery 

01 Total Elbow Replacement
02 Partial Elbow Replacement
03 Hinged Elbow Replacement
04 Non-Hinged Elbow Replacement

This is the type of surgery suggested when both ends of the arm bone (humerus) and the forearm bone (ulna), which contribute to the formation of the elbow joint, are severely and irreparably damaged.

Partial elbow replacement surgery is effective when only one of the two joint surfaces is damaged beyond repair, and the other bone contributing to the elbow joint can be repaired/salvaged.

This type of elbow replacement is reserved for unstable elbow joints where a “hinge” is used to link the two surfaces of the replaced elbow and innate stability is achieved by the “hinge” and not from the elbow's own ligaments, which have failed to provide stability to the elbow which is often seen in cases such as post-traumatic ligament injuries when multiple ligament injuries to the elbow have been treated inadequately or have failed following attempts at repair following the damage to ligaments.

This is the more standard/ traditional type of elbow replacement surgery where the two ends of bones forming the elbow joint are replaced using separate or “unlinked” components. The ultimate indication for choosing this form of elbow replacement is for an elbow which is otherwise stable and does not depend on the replacing components to provide the joint with stability. In other words, this type of elbow replacement depends on the normal innate stability of the elbow joint provided by the naturalised ligaments of the individual's elbow.

When Will You Require Elbow Replacement

Like all other conditions/ diseases and joints, the elbow/ joint replacement surgery should and will only be considered when all other modalities of conservative management (ice packs, pain killers (in moderation), physiotherapy and rehabilitation have failed or produced satisfactory results in patient needs.

Also, The age of the individual plays a significant role during consideration for elbow replacement. Age groups below 50 to 60 years of age are rarely recommended elbow replacement surgery due to the higher physical demand from their elbow of younger individuals and the limited longevity of elbow replacement prosthesis. Only under exceptional circumstances will an elbow replacement surgery be suggested for individuals belonging to age groups under 50 to 60 years.

Indications for Elbow Replacement Surgery

The commonest indications (requirement) for elbow replacement surgeries are those who suffer from one of the (but not limited to) the following conditions:

Rheumatoid Arthritis (RA): This results in elbow arthritis, damage to the joint surface resulting in severe pain and, in more advanced stages, total or near total stiffness of the joint (fused bones of the elbow joint which prevent further movement of the elbow joint).
Osteoarthritis: Primary (Age-related) arthritis of the elbow needing replacement surgery is far less common when compared to the knee or hip. However, irreversible joint damage following fractures of the elbow joint (post-traumatic arthritis or secondary arthritis), which result in damage to the elbow joint surface, can result in secondary arthritis of the elbow, which could result in the individual requiring elbow replacement.
Severe fractures: These are fractures involving the joint contributing ends of the bones of the elbow and may sometimes be considered for total or partial elbow replacement depending on the severity of the joint damage and when bone salvage (internal fixation) of the fracture ends is predicted to be more detrimental to the individual than actually replacing the severely damaged portions.
Elbow instability: Severe instability of the elbow, which is beyond repair or reconstruction, could require elbow replacement surgery.

Myths That We Break Surrounding Elbow Replacement Surgeries

Technological advancements in the field of joint replacement surgeries as a whole, especially elbow replacements, have made it a very safe and patient-friendly procedure.

A decorative icon illustrating elbow pain.
Elbow Surgery is Solely for Athletes.
Elbow surgery is a versatile solution that caters to a wide range of individuals, not just athletes. It's suitable for those who have endured injuries, are dealing with degenerative conditions, or suffer from chronic pain that impacts their daily lives.
A decorative icon illustrating Elbow Surgery.
Elbow Surgery is Inherently Risky and Unsafe.

Elbow surgeries are carried out by skilled orthopaedic surgeons committed to ensuring patient safety. While all surgeries entail some level of risk, advances in medical technology have greatly enhanced the safety and effectiveness of elbow procedures.

A decorative icon illustrating the recovery period.
Elbow Surgery Needs a Prolonged Recovery Period.

Recovery times after elbow surgery are variable and depend on factors such as the type of procedure, an individual's health, and their adherence to post-operative instructions. In many cases, minimally invasive approaches lead to faster recoveries, enabling patients to resume regular activities more swiftly.

Planning for Elbow Replacement Surgery

Pre-Operative Period
Types Of Anesthesia
The Procedure
Step 1: Consultation

Consultation with your joint replacement surgeon involves meeting with Dr. Balaji Subramanian. During this consultation, you will discuss how your elbow problem developed and the specific demands or requirements you have for your elbow. Dr. Balaji Subramanian will conduct a comprehensive physical examination. Based on your information and his examination, the need to assess the extent of joint damage will be determined. This assessment will be done through an appropriate form of radiological imaging, which will be selected based on your specific needs.

Step 2: Radiological Imaging

Simple X-ray of the elbow: The most basic form of imaging modality to visualise the elbow joint is the X-ray. Many (but not all) details can be obtained from viewing an X-ray. Note: An X-ray primarily reveals the bone and provides limited details. For a more comprehensive examination of the bone and the ligaments surrounding the elbow, a CT scan or an MRI scan of the elbow may be necessary.

X-ray showing severe destruction of the right elbow joint in a patient.X-ray of an elbow showing severe destruction of the right elbow joint in a patient.

X-ray showing severe destruction of the right elbow joint in a patient with rheumatoid arthritis.

  • CT scan: Provides a more accurate and detailed image of the bones of the elbow. The CT scan provides a more precise insight into the state of the bones forming the elbow joint and the extent of their damage.
  • MRI scan: Provides a good visualisation of most structures surrounding the elbow joint, including the bones, muscles, and ligaments that contribute to the stability of the elbow joint. It is usually suggested in suspected cases of elbow instability alone and NOT for all cases.

After obtaining the necessary details, the various options, benefits and limitations (if any) will be discussed with you.

Ultrasound-guided regional anesthesia

This is our preferred type of anaesthesia for upper limb surgeries and involves an injection for the upper limb on which the elbow surgery is going to be performed. This type of anaesthesia is safe and accurate, requires minimal use of any anaesthetic agent and, most importantly, continues to provide a pain-free experience for the patient even several hours after the surgery. Also, in this form of anaesthesia, the patient can be awake throughout the surgery with complete numbness of the limb through the entire duration of the procedure, providing a very safe and painless intra-operative experience for the patient.

General Anesthesia

It is the type of anaesthesia where the patient is fully anaesthetised during the surgery. The patient will be awakened by the completion of the surgery when they are ready to be shifted out of the operating theatre.

During the surgery, the damaged portion of the joint (partial or total elbow) will be prepared for the introduction of the medical-grade joint replacement implant. The implant, as mentioned earlier, may be partial/ total/ hinged or non-hinged. Preparations to introduce one of the above types of implants will be made according to the type of procedure being performed or the type that the damaged elbow requires.
Post-Operative Period

You may be required to stay in the hospital for a few days to provide adequate pain relief, monitor the progress of the operated elbow and begin physical rehabilitation exercises to help you achieve peak performance with your new functional elbow.

Expected Results
Elbow replacement surgeries (whichever type) are safe and help reduce pain and improve the range of movement which the patient has sadly lost due to injury or disease. Although less commonly performed around the world compared to other joints (knee/ hip/ shoulder), the success rates for elbow replacement surgeries are fairly high, with excellent results over 10 years.
Pre and post-surgery X-rays of elbow replacement surgery in a patient.Pre and post-surgery X-rays of elbow replacement surgery in a patient at Sri Balaji hospital.
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