Total Elbow Replacement: Procedure and Outcomes

Joint replacement surgeries have been performed for more than 100 years. The first elbow replacement was performed by Robineau in 1925. Elbow replacement used to be a complex procedure in the early times, but with the advancements in medical technologies, the surgery is now much easier without any significant complications.

Total elbow replacement, or TER, is performed by an orthopedic surgeon. Countries like India, Germany, and UAE have some of the best surgeons in the world. If you want a cost-effective elbow replacement surgery without compromising the quality, you can opt for any of the countries mentioned above.

The cost of total elbow replacement in India averages around INR 3,00,000 or USD 5,000. Turkey offers similar treatment for USD 8,000 but with slightly better facilities.

In this blog, we will understand what TER is, how it is performed, and the surgery cost.

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What is Total Elbow Replacement?

A total elbow replacement (TER) or elbow arthroplasty is a surgery to correct the deformities in the elbow joint. The surgery involves replacing the damaged/deteriorated elbow joint with an artificial one (prosthesis).

The elbow arthroplasty is done to restore the mobility and functioning of the elbow joint, reduce pain, and improve the quality of life. The artificial joint may be linked (the implants are connected with the help of a hinge) or unlinked (the metal stems are linked using the body's tissue).

Why is Total Elbow Replacement Done?

A total elbow replacement is required when the bone or cartilage in the elbow joints gets damaged. The damage to the elbow joint causes pain and reduces the range of motion. Several conditions can lead to deteriorating elbow joints. These are:

• Rheumatoid Arthritis
• Osteoarthritis
• Posttraumatic Arthritis
• Severe Fractures
• Chronic Instability

Any of the conditions mentioned above can lead to total elbow replacement.

How to Prepare for Total Elbow Replacement?

Consultations before the surgery are done to evaluate the patients and also to give them proper instructions to be followed for successful results. The visits to the surgeon's office include:

• A physical exam
• Review of symptoms
• Imaging tests like X-rays, MRI, and CT scans

The surgeon will ask to stop some medication that may cause excessive bleeding. These include blood thinners, NSAIDs, and arthritis medications.

How is Total Elbow Replacement Performed?

• For total elbow arthroplasty, the patient is sedated using general anesthesia and a nerve block. 
• Once the patient is in a state of deep sleep, the surgeon makes an incision at the back of the elbow. The muscles are moved aside to access the bone. 
• The humerus is then prepared to fit the metallic stem, which will replace that side of the joint. The same procedure is repeated for the ulna bone.
• The replacement stems can be connected using a hinge (linked) or natural ligaments (unlinked). The unlinked elbow replacements can be done only in patients that do not have ligament injuries.
• The implants used for the TER are usually made up of cobalt-chrome alloy or titanium. The liner of the implants is made up of polyethylene.
• The incision or the cut is then closed using sutures, and a padded dressing is placed over the wound to help it heal better. 
• The surgeon might place a drainage tube in the joint that can be easily removed after a few days. The tube helps in removing the surgical fluid.

What is it Like to Recover from Total Elbow Replacement?

• Once the surgery is complete, the staff will take you to the recovery room. The total hospital stay depends on the individual's needs.
• The surgical team will prescribe several doses of antibiotics to prevent any infection. 
• It's normal to feel some pain for a few days after TER. The doctor will advise medicines like opioid analgesics, NSAIDs, and local anesthetics for pain management.
• You'll be asked to use a splint/sling for some weeks after the surgery. 
• The rehabilitation will include some exercise of the hand and wrist to avoid swelling and stiffness. Keeping the arm elevated will also help in reducing the swelling.
• As the incision heals, you can do gentle range of motion exercises.  
• The patient must wait a minimum of 6 weeks before putting weight on the arm or pushing against resistance.

What are the Outcomes of Total Elbow Replacement?

With the advancements in surgical techniques and better implant designs, total elbow arthroplasty has improved a lot in recent times. The surgery now has better outcomes compared to a few decades back. 

Over 80% of elbow replacements will last more than 10 years. However, you must undergo this procedure in a renowned hospital that has modern medical equipment to give better results. Countries like India, Turkey, UAE, and Germany have state-of-the-art orthopedic hospitals you can trust for your TER.

The recovery from total elbow arthroplasty usually takes around three months. Once the patient has recovered, they can do day-to-day activities which were challenging to do before surgery. 

The long-term outcomes of the total elbow replacement include:

• A better range of motion
• Less pain 
• Improved quality of life
• Better functioning
• An increase in strength

You may be asked to avoid a few activities like contact sports (football), activities with a risk of falling (horse riding), and heavy lifting (weight restriction to 5-10 pounds).

What is the Cost of Total Elbow Replacement?

The cost of total elbow replacement depends on various factors:

• The country you opt for
• Type of hospital and room selected
• Severity of disease
• Type of implant used 
• Surgeon's fees
• Postoperative complications
• Extended stay

Countries like India, Germany, and Turkey offer affordable treatment plans for TER. The cost of elbow replacement surgery in India starts from INR 2,44,000 and can go up to INR 3,30,000. International patients can expect the price to be in the range of USD 5,000 to 6,000.

If you are ready to spend more for better facilities, you can opt for Turkey. Elbow replacement surgery cost in Turkey is around USD 8,000 to 10,000. The country observes hundreds of patients each year for TER.

The prices mentioned above include preoperative diagnostic tests, surgery costs, cost of the implant, hospital stay, physiotherapy, and postoperative costs.

To Conclude

Total elbow replacement is a complex arthroplasty procedure that must be done by a skilled surgeon at a well-established hospital to give desired outcomes. Medications like DMARDs can control conditions like rheumatoid arthritis that lead to TER. But once the disease has progressed, getting an elbow replacement procedure is the only option. TER significantly improves the range of motion, joint functioning, and patient quality of life.