? Quick Facts from Prof. Dr. Göçer
- Elbow replacement is a surgical procedure in which a damaged joint is replaced with an artificial joint in cases of advanced elbow arthritis or irreparable fractures.
- The most common causes are rheumatoid arthritis, osteoarthritis, and, particularly in the elderly, irreparable fractures around the elbow.
- The 10-year implant survival rate for modern elbow prostheses has been reported to average 83% in registry data (Finnish Arthroplasty Registry).
- Elbow replacement is a less common procedure than hip or knee replacement and requires specialized experience; patient selection directly impacts the outcome.
When the elbow joint is severely damaged, even the simplest daily movements of the arm become difficult. Elbow replacement is a surgical procedure in which an elbow joint that has lost its function due to advanced arthritis or an irreparable fracture is replaced with an artificial joint to reduce pain and restore movement.
What Is an Elbow Replacement?
Elbow replacement is a surgical procedure in which the damaged surfaces of the elbow joint are replaced with an artificial joint made of metal and special plastic components. The goal is to reduce pain and restore the arm’s ability to bend and straighten. In medicine, this procedure is also known as “total elbow arthroplasty.”
The main indications for elbow replacement include advanced rheumatoid arthritis, elbow osteoarthritis, post-traumatic arthritis, and, particularly in elderly patients, irreparable fractures of the distal humerus. Historically, the most common cause was rheumatoid arthritis, but today complex fractures have become an increasingly important indication.
Elbow Replacement and Its Types
Elbow prostheses are primarily classified into two types based on their design: “linked” prostheses, in which the components are connected by a hinge, and “unlinked” prostheses, which move independently. Additionally, partial prostheses that replace only a portion of the joint may be used in certain cases. The appropriate type is determined based on the condition of the bone and ligament structure.
- Total elbow prosthesis: Replacement of both the upper arm (humerus) and forearm (ulna) sides of the joint
- Linked (hinged) prosthesis: Provides stability in patients with weak ligament structures
- Unlinked prosthesis: Suitable for patients with well-preserved bone and ligament structures
According to Prof. Dr. Hasan Göçer, the most critical step in elbow replacement surgery is selecting the right patient and the right type of prosthesis; because the elbow is a smaller and more complex joint than the hip or knee, patient selection and surgical experience directly impact the outcome.
Elbow Replacement Surgery
Elbow replacement surgery is typically performed under general anesthesia. The surgeon removes the damaged joint surfaces and replaces them with artificial components. Since the nerves surrounding the elbow (especially the ulnar nerve) are in close proximity, so protecting them is a crucial part of the surgery.
- Anesthesia is administered and the elbow area is prepared
- The elbow joint is accessed; the ulnar nerve is dissected while being protected
- The damaged joint surfaces are removed
- The humerus and ulna components are implanted
- Joint stability is checked, and the tissue layers are closed
Prof. Dr. Göçer emphasizes that, in clinical practice, patients who have undergone elbow replacement surgery must be permanently restricted from lifting heavy loads with their arm; because while elbow replacement reduces pain and restores movement, heavy and repetitive loading can shorten the prosthesis’s lifespan.
Cost and Reimbursement of Elbow Replacements
The cost of an elbow replacement varies depending on the type of prosthesis, the components used, and the scope of the surgery; therefore, it would not be accurate to provide a standard figure. Reimbursement conditions are determined within the framework of relevant social security regulations. For up-to-date information on costs and reimbursement, it is advisable to contact the healthcare facility you are applying to and your social security agency.
Clinical Assessment by Prof. Dr. Hasan Göçer
“In my clinical practice, I view elbow replacement as a procedure that can make a significant difference in the right patient but can be challenging in the wrong one. Especially in an elderly patient with a comminuted and irreparable elbow fracture, the prosthesis can restore a pain-free and mobile arm. However, I set a clear rule for the patient from the start: this arm is not meant for carrying heavy loads, but for comfortably carrying out daily activities. Adhering to this limit is the key to the prosthesis’s longevity.”
Prof. Dr. Hasan Göçer — Specialist in Orthopedics and Traumatology
The practical significance of this assessment is that the success of an elbow prosthesis depends not only on the surgery itself but also on the patient’s postoperative lifestyle. Avoiding heavy loads and adhering to physical therapy directly affect the prosthesis’s lifespan and the patient’s satisfaction.
From Diagnosis to Recovery: How Does the Process Proceed?
| Stage | Time | What Happens? |
|---|---|---|
| Initial Examination | Day 1 | Assessment of elbow range of motion and pain; X-ray (CT scan if necessary) is ordered |
| Evaluation & Planning | Weeks 1–2 | Joint damage is assessed via imaging; prosthesis type and surgical plan are determined |
| Surgery | Scheduled day | Total elbow replacement is performed under general anesthesia; the ulnar nerve is preserved |
| Hospital Stay | Days 1–3 | Maintenance of the arm in the proper position, pain management, wound monitoring, discharge |
| Recovery | Weeks 6–12 | Controlled range-of-motion exercises, avoidance of heavy lifting, and follow-up visits |
Initial Examination and Planning: Elbow range of motion, pain, and the status of the fracture or arthritis are assessed. Imaging is a key factor in selecting the type of prosthesis.
Surgery and Hospital Stay: Protection of the ulnar nerve is a critical part of the surgery. After surgery, the arm is immobilized in an appropriate position to support healing.
Recovery: Range of motion is regained through controlled exercises. Avoiding heavy loads is critical for ensuring the prosthesis’s longevity.
Frequently Asked Questions
Is a “platinum” prosthesis the same thing as a prosthesis?
No, they are not the same thing. What is commonly referred to as “platinum” consists of plates and screws used to stabilize a broken bone; once the bone has healed, they fulfill their purpose. A prosthesis, on the other hand, is the complete replacement of a damaged joint with an artificial one. A fracture fixation device repairs the bone, while a prosthesis replaces the joint; they serve different purposes.
Does SGK cover elbow prostheses?
Reimbursement conditions vary depending on social security regulations and the patient’s condition; therefore, it would not be accurate to specify a definitive percentage here. For the most up-to-date coverage and reimbursement information, it is best to contact the Social Security Institution and the healthcare facility where you are seeking treatment.
How is elbow replacement surgery performed?
The surgery is performed under general anesthesia. The surgeon accesses the elbow joint, protects the ulnar nerve, removes the damaged joint surfaces, and implants the humerus and ulna components. Joint stability is checked at the end of the procedure. After surgery, the arm is immobilized for a period of time to support healing.
How long does an elbow prosthesis last?
According to recorded data on 10-year implant survival rates for modern elbow prostheses, the average survival rate is reported to be 83%. In other words, the prosthesis remains functional for many years in the majority of patients. Durability varies depending on the patient’s age, diagnosis, and—most importantly—whether they avoid heavy loads.
Conclusion
In this article, we discussed what an elbow prosthesis is, its types, how the surgery is performed, and the recovery process. When performed on the right patient with the appropriate type of prosthesis, an elbow prosthesis is a valuable option that reduces pain and restores arm function; however, avoiding heavy loads is key to long-term success.
You can begin the consultation process to evaluate your personal situation regarding elbow replacement. Prof. Dr. Hasan Göçer evaluates appropriate treatment options by addressing each patient’s clinical presentation individually.
References
- Prasad N et al. Primary total elbow arthroplasty: indications and outcomes. NIH PMC, 2021 — https://pmc.ncbi.nlm.nih.gov/articles/PMC8099774/
- Skyttä ET et al. Total elbow arthroplasty in rheumatoid arthritis: Finnish Arthroplasty Register (10-year survival rate 83%). NIH PMC — https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2823192/
- Welsink CL et al. Total Elbow Arthroplasty: A Systematic Review. JBJS Reviews / PubMed, 2019 — https://pubmed.ncbi.nlm.nih.gov/30635202/
