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What is Revision Elbow Replacement?

Revision elbow replacement is a surgery performed to replace a loose or worn out initial elbow replacement. Typically, cemented semi-constrained prostheses are used for revision elbow replacement.

The procedure, also called ‘revision elbow arthroplasty’, can often be more complicated than the original replacement surgery.

Causes

Several factors can contribute to revision elbow replacement. They include:

  • Dislodgement of the replaced elbow
  • Damage or fracture to the replaced elbow
  • Infection after the initial elbow replacement
  • Aseptic loosening of the implant or prosthesis
  • Instability of the initial replacement
  • Failure of the initial implant or prosthesis

Indications

Persistent pain in your elbow long after the initial replacement is the obvious indication for revision elbow replacement.

Diagnosis

Blood tests and an X-ray of your elbow can confirm the failure of the initial elbow replacement.

What are the Nonoperative Options?

Nonoperative options for revision elbow replacement predominantly include:

  • Physical therapy
  • Splinting the elbow
  • Medications

What are the Operative Options?

Reimplantation (including cement-within-cement technique) can be a viable and reliable option for the revision elbow replacement. Other surgical options include:

  • Tension band fixation
  • Allograft struts with cerclage wire or plate and screw constructs

Occasionally, recurrent infections may occur after these procedures.

What Happens After Your Surgery?

A bandage or a plaster (slab) will be applied to your new elbow soon after the surgery. You will be advised to keep your arm in a splint while the surgery wound heals. Additionally, the doctor may prescribe a medication regime (or a combination of medications) for relief from pain.

Your Rehabilitation

A carefully planned and well-organised rehabilitation programme is the key to the success of a revision elbow replacement. Your doctor will make every effort to design an individualised rehabilitation regime as the wound heals. You are expected to stick to the rehab programme until your elbow fully recovers for the best results.