Total Elbow Replacement Surgery Cost in India

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What is Total Elbow Replacement?

In total elbow replacement surgery, the damaged parts of the humerus and ulna are replaced with artificial components. The artificial elbow joint is made up of a metal and plastic hinge with two metal stems. The stems fit inside the hollow part of the bone called the canal.

Risk factors for overall TEA failure

• smoking
• significant medical co-morbidities 
• non-compliance with activity restrictions
• non-constrained system (dislocation)
• highly constrained system (loosening)

Symptoms 

• squeeking
• elbow crepitus or "squeaking" sound with motion
• pain
• elbow pain
• pain at night or rest is a red flag for infection
• swelling
• stiffness
• decrease motion after a period of normal motion
• progressive loss of motion without identifiable cause is red flag for infection

Physical exam 

• inspection 
• erythema/sinus tract in the setting of infection
• diffuse tenderness
• elbow swelling
• deformity 
• in cases of significant bushing wear
• motion 
• painful and limited range of motion
• crepitus/squeaking during motion

Some below mentioned diagnosis:

Radiographs 

1. Recommended views 
2. AP and lateral of humerus, elbow, and forearm

Findings 

1. periprosthetic component loosening
2. early unexplained loosening concerning for infection
3. periprosthetic humeral or ulnar fractures
4. polyethylene bushing wear
5. angle of intersection between the ulnar implant in relation to the humeral implant is measured 
6. mild-moderate bushing wear is considered when the angle > 10 degrees 

CT

Indications

1. assess for peri-prosthetic osteolysis or loosening
2. can be useful to determine if cement mantle is intact or broken in cases of peri-prosthetic fracture

MRI 

Indications 

To evaluate for abscess or soft tissue infection

Surgery

In elbow surgery, the damaged portions of the elbow bones are removed, and the elbow is replaced with implants. Here's what you can expect on a typical day of elbow surgery:

• A small tube (intravenous line) is inserted into your unaffected arm. This tube is used to administer antibiotics and other medication during your surgery.
• You're taken to the operating room and given anesthesia.
• Anesthesia takes effect and your elbow is scrubbed and sterilized with a special solution.
• Your elbow replacement surgery will likely take between one and three hours and begins with an incision over your elbow to expose the joint.
• Bones are fully visible to the surgeon, and special precision guides and instruments are used to remove the damaged surfaces and cut and shape the ends of the humerus (upper arm bone) and ulna (forearm bone) to accept the implants.
• The implants are inserted and fixed into place with a special kind of epoxy cement for bones.
• The two parts of the hinge are then brought together and secured with a locking pin.
• When the surgeon is satisfied with the fit and function, the incision is closed and covered with dressings.
• A sterile bandage is applied.
• Your arm is put in a splint and may also be wrapped in an ice pack to help control pain and swelling.
• You're taken to the recovery room where you will be closely monitored.
• Anesthesia wears off, and you slowly regain consciousness. A nurse is with you and may encourage you to cough or breathe deeply to help clear your lungs. You're given pain medication.
• Your elbow remains swollen and tender for a few days.

Frequently asked questions

Q. How long does a total elbow replacement last?

There's a very good chance that your shoulder or elbow replacement will last for 10 years. After this time it may loosen or wear out. A second joint replacement (revision surgery) may then be possible, although it's usually not so effective in easing symptoms.

Q. How long does it take to recover from elbow replacement surgery?

You may be able to start using your elbow as soon as 12 weeks after surgery. Full recovery can take up to a year.

Q. What is a total elbow replacement?

In total elbow replacement surgery, the damaged parts of the humerus and ulna are replaced with artificial components. The artificial elbow joint is made up of a metal and plastic hinge with two metal stems. The stems fit inside the hollow part of the bone called the canal.

Q. How is elbow surgery done?

Elbow replacement surgery is the same idea as having worn parts taken out and new parts installed in their place. In elbow surgery, the damaged portions of the elbow bones are removed, and the elbow is replaced with implants.

Q. How should I sleep after elbow surgery?

The best position is lying down with two pillows under your arm or with your arm in a Carter pillow. Elevation should be done for the first several days after surgery.

Q. How long is physical therapy after elbow surgery?

You can start to do strengthening exercises with light weights about 3 weeks after your surgery. A physical therapist can show you the right exercises to improve your elbow strength. You should be able to go back to work 6 to 12 weeks after your surgery.

Q. How long does it take to get full range of motion after elbow surgery?

Elbow motion is ultimately recovered during the first 6 to 8 weeks, patients can continue to make gains in terminal flexion and extension for several months postoperatively.