What is the procedure?
Total elbow replacement is an operation where the damaged joint surfaces of the elbow are removed and replaced with artificial components made of metal and plastic. The components typically function as a hinge, allowing bending and straightening while providing stability.
The operation is used for advanced elbow arthritis that causes significant pain and functional limitation. It may also be used in selected complex fractures in older patients when stable fixation is unlikely.
Who is it for?
Elbow replacement is usually best suited to people with severe arthritis pain that persists through the mid-range of motion and interferes with daily activities. It is often used for inflammatory arthritis such as rheumatoid arthritis, advanced osteoarthritis, or post-traumatic arthritis when other options are unlikely to help.
Because elbow implants have long-term loading limits, elbow replacement is usually recommended for lower-demand patients or those who can accept permanent lifting restrictions.
What happens during surgery?
Surgery is performed under general anaesthetic. The surgeon prepares the humerus and ulna and inserts the implant components. The joint is stabilised and the wound is closed.
Post-operative protocols vary depending on the implant type and soft tissue condition. Your surgeon will advise the plan for motion and protection.
Recovery and rehabilitation
Early gentle motion is usually started under guidance. Physiotherapy focuses first on regaining comfortable motion and then on functional use within safe limits.
A permanent lifting restriction is commonly advised to reduce the risk of implant loosening. Your surgeon will discuss specific limits and activity modifications.
Expected outcomes
Most patients experience meaningful pain relief and improved ability to perform daily activities. The aim is to restore comfortable function rather than heavy lifting or high-impact sport.
Risks and complications
Risks include infection, wound problems, nerve irritation, stiffness, implant loosening, implant wear, fracture around the implant, instability, and the possibility of revision surgery later in life.
When should I seek urgent review?
Seek urgent medical review if you develop increasing redness, heat, rapidly worsening swelling, fever, increasing pain that does not settle with rest, or new weakness or numbness in the hand. If you have had a recent injury and the elbow looks deformed, feels unstable, or you cannot move it, this also requires urgent assessment.
Surgery, Risks and Recovery
Surgery is considered when symptoms persist despite appropriate non-operative treatment, when imaging or nerve studies confirm structural pathology, or when weakness, locking, or mechanical symptoms are present.
Operations are usually performed as day procedures under regional or general anaesthetic. Techniques depend on the underlying condition and may involve tendon debridement or repair, arthroscopic bone spur removal, loose body excision, fracture fixation, ligament reconstruction, nerve decompression, or joint replacement.
General risks include infection, bleeding, stiffness, scar sensitivity, nerve irritation, persistent symptoms, recurrence, and the need for further surgery. Condition-specific risks are discussed prior to surgery.
Recovery varies according to the procedure performed. Gentle motion is usually encouraged early. Wounds typically heal within two weeks. Light activities resume over two to four weeks for minor procedures, while larger reconstructions or replacements may require several months of rehabilitation.
Patients often notice improvement within six to twelve weeks, although full recovery may continue for up to a year depending on the pathology treated.
What does the rehabilitation/recovery involve?
To find out more about rehabilitation and recovery after elbow surgery please see our Rehabilitation Protocols here.