Total elbow joint replacement for elbow arthritis: Surgery with a dependable, time-tested prosthesis can lessen pain and improve function in elbows, especially those with rheumatoid arthritis.
Edited By: Frederick A. Matsen III, M.D., Winston J. Warme, MD
Last updated Tuesday, November 13, 2007
RehabilitationPhysical therapy After the surgical wound is healed, establishing good elbow motion is a priority.
Elbow motion soon after total elbow replacement helps achieve best
possible elbow function. Arthritic elbows are often stiff. One of the
major goals of total elbow replacement surgery is to restore motion to
the joint. However, after surgery scar tissue will tend to recur and
limit movement unless motion is started soon afterwards. This early
motion is facilitated by the complete surgical removal of the tight
tissues so that after surgery the patient needs to only maintain the
range of motion achieved at the operation. Later on, once the elbow is
comfortable and flexible, strengthening exercises and additional
activities are started. Rehabilitation options It is often most effective for the patient to carry out their own
exercises so that they are done frequently, effectively and
comfortably. Usually, a physical therapist or the surgeon instructs the
patient in the exercise program and advances it at a rate that is
comfortable for the patient. For the first six weeks after surgery, the
emphasis is on optimizing the flexibility and range of motion of the
elbow through gentle stretching exercises. After six weeks, these
stretching exercises are continued and strengthening exercises may be
added.Can rehabilitation be done at home? In general, the exercises are best performed by the patient at home.
Occasional visits to the surgeon or therapist may be useful to check
the progress and to review the program.Usual response Patients are almost always satisfied with the increases in range of
motion, comfort, and function that they achieve with the exercise
program. If the exercises are uncomfortable, difficult, or painful, the
patient should contact the therapist or surgeon promptly.Risks This is a safe rehabilitation program with little risk.Duration of rehabilitation Once the range of motion and strength goals are achieved, the exercise
program can be cut back to a minimal level. However, gentle stretching
is recommended on an ongoing basis.Returning to ordinary daily activities In general, patients are able to perform gentle activities of daily
living using the operated arm beginning two to six weeks after surgery.
Walking is strongly encouraged. Driving should wait until the patient
can perform the necessary functions comfortably and confidently. This
may take six or more weeks if the surgery has been performed on the
right elbow, because of the increased demands on the right elbow in
shifting gears.Long-term patient limitations Patients should avoid activities that involve impact (hammering,
chopping wood, contact sports, sports with major risk of falls) or
heavy loads (lifting of heavy weights, heavy resistance exercises).
These activities may increase the chance of loosening, wear or fracture.Costs The surgeon and therapist should be able to provide information on the
usual cost of the rehabilitation program. The program is quite cost
effective, because it is based heavily on home exercises.Surgery for Elbow arthritis at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-7416 to make an appointment.
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