About This Procedure
Elbow replacement — total elbow arthroplasty — is a well-established procedure for patients whose elbow joint has been destroyed by arthritis, inflammatory disease, or unreconstructable fracture. When the joint surfaces are too damaged for repair or resurfacing, replacement provides reliable pain relief and functional motion restoration.
Dr. Jay Levin performs elbow replacement at Duke Health in Durham, drawing on expertise in upper extremity arthroplasty and fracture management. Patients from Durham, Cary, Chapel Hill, and throughout North Carolina are evaluated and treated for end-stage elbow conditions that have not responded to non-operative management.
The most common indication is rheumatoid arthritis, which can erode elbow cartilage and bone, leaving patients with a painful, stiff, unstable joint. Post-traumatic arthritis — following a prior elbow injury — is another common cause. In elderly patients with complex distal humerus fractures, elbow replacement (often preferred over internal fixation) can provide immediate stability and faster return to function.
The Procedure
Elbow replacement is performed under general anesthesia, often combined with a regional nerve block. Dr. Levin makes an incision along the back of the elbow, carefully protecting the ulnar nerve — a critical structure that must be identified and safeguarded throughout the procedure.
The damaged surfaces of both the humerus (upper arm) and ulna (forearm) are prepared and fitted with metal and polyethylene components linked by a hinge mechanism. This linked design provides inherent stability and is appropriate for most indications, including fractures and inflammatory arthritis. The incision is closed in layers, and the arm is placed in a splint to protect the repair.
The procedure typically takes 1.5–2.5 hours. Dr. Levin uses careful intraoperative technique to minimize complications and ensure durable implant fixation.
Recovery at Duke Health
After elbow replacement, your arm will be in a splint for 2–3 weeks. Gentle range-of-motion exercises begin early — often within the first 1–2 weeks — guided by a Duke Health physical therapist. Early motion is important to prevent the elbow stiffness that commonly accompanies prolonged immobilization.
Over the next 6–12 weeks, motion and functional strength improve progressively. Most patients in the Durham and Cary area reach their best functional outcome by 3–6 months post-surgery.
A permanent lifting restriction of 5–10 pounds applies to patients with total elbow replacement, to protect the implant from excessive wear or loosening. Dr. Levin counsels all patients on this restriction preoperatively and helps them adapt their daily and recreational activities to protect their long-term outcome.