Total elbow Arthroplasty and Hemiarthroplasty
Total elbow arthroplasty is reserved for severe arthritis of the elbow and the most severe fractures that cannot be reconstructed in individuals over 65-70 years old. It is a good pain relieving procedure but is not robust like hip, knee and shoulder replacement. I have very narrow indications for this procedure and stress the importance of adhering to a 2 pound lifetime lifting restriction. Hemiarthroplasty is not FDA approved, but an option for severe fractures in younger patients that cannot be repaired. It retains the ligamentous stability of the elbow that is sacrificed or not present in total elbow arthroplasty.
1-14 days: Usually one or two nights in the hospital. Discharged home when pain controlled with oral pain meds and drain output is minimal. Keep incision covered and dry. Gentle passive ROM is allowed. Patients will be notified of whether or not the triceps attachment was preserved or peeled from the bone. This dictates whether or not active elbow extension is allow. Ice three times daily, 20 minutes at a time. No NSAIDs or nicotine. No lifting.
2-6 weeks: Continue Ice and passive ROM. May bathe normally. No lifting, pushing or pulling.
6-12 weeks: May increase active extension regardless of how the triceps was managed. Begin activities of daily living such as feeding, grooming and other simple activities. Remember the 2 pound lifting restriction. Hemiarthroplasty may begin to increase weight bearing at this point.
3 months+: Total elbow arthroplasty maintains limited lifting and slowly increases ROM. Hemiarthroplasty may advance to activities as tolerated. Some lifting limitation may apply.
1-14 days: Usually one or two nights in the hospital. Discharged home when pain controlled with oral pain meds and drain output is minimal. Keep incision covered and dry. Gentle passive ROM is allowed. Patients will be notified of whether or not the triceps attachment was preserved or peeled from the bone. This dictates whether or not active elbow extension is allow. Ice three times daily, 20 minutes at a time. No NSAIDs or nicotine. No lifting.
2-6 weeks: Continue Ice and passive ROM. May bathe normally. No lifting, pushing or pulling.
6-12 weeks: May increase active extension regardless of how the triceps was managed. Begin activities of daily living such as feeding, grooming and other simple activities. Remember the 2 pound lifting restriction. Hemiarthroplasty may begin to increase weight bearing at this point.
3 months+: Total elbow arthroplasty maintains limited lifting and slowly increases ROM. Hemiarthroplasty may advance to activities as tolerated. Some lifting limitation may apply.