When you arrive for an elbow replacement operation, your surgeon will give you either a “general anesthetic” that will help you sleep through the entire operation or a “regional anesthetic” that only blocks some nerves to the elbow and arm. If your doctors think a regional is best, you will receive another medicine to help you relax.
After anesthesia is given, your elbow is cleaned and draped with sterile cloths or paper. Next, an incision (cut) is made along the back of the arm to let the doctor access your elbow joint without hurting the muscles and nerves. Your surgeon will carefully protect the nerve on the inside of the elbow and reposition the elbow to successfully protect it during the surgery. Because of this, you may experience some temporary numbness in your little finger right after surgery.
The surgeon will look at the muscles, cartilage and other tissues near the elbow for scar tissue or other things that might stop movement of the new joint. If these are found, they are removed.
An elbow implant is made up of two parts. The “humeral” component is placed in the lower end of the upper arm bone also known as the humerus. The “ulnar” component replaces the elbow portion of the ulna or large bone of the forearm, which cups around the end of the humerus.
Your surgeon will remove a portion of the bone at the lower end of the humerus and the upper end of the ulna. A space in the middle of each bone is hollowed out using a special tool. The pieces of the new joint are inserted into the marrow of the bone. When proper placement of the implants has been achieved, the final components are cemented into the bones using “bone cement.”
Once the two parts of the elbow implant are firmly in place, they are linked together using a pin, just like two parts of a door hinge. Once this is completed, the soft tissues are sewn together and a dressing is applied. Often, a splint will be applied to protect the elbow from sudden movements.
You will probably be sent to a special recovery room for an hour or two after the operation. While in recovery, nurses will carefully monitor your vital signs-heart rate, blood pressure, respirations and bleeding until the anesthetic wears off and you are more awake. At that time, you will probably be sent to a regular hospital room to start your recovery.
Elbow replacement surgery is a major operation. It involves cutting the skin, tendons and bone. The pain from this surgery is managed using pain medications. At first, the drug is given either into a muscle or using a vein. Sometimes, a patient controlled pump is used so that you can give yourself pain medicine, as you need it.
After a day or two, you will probably be switched to a pain drug taken by mouth that you may need for up two weeks after surgery.
Sometimes, depending on your surgeon, your elbow will be placed in an elbow splint. Basic range-of-motion exercises are started soon after you leave the recovery room. On the second day after surgery, you will begin your physical therapy program.