Elbow replacement - discharge

While in the hospital, you should have received pain medicine. You also learned how to manage swelling around your new joint.

Your surgeon or physical therapist may have taught you exercises to do at home.

Your elbow area may feel warm and tender for 2 to 4 weeks after surgery. The swelling should go down during this time.

For the first week after surgery, you may have a soft splint on your arm to hold your elbow in place. After the incision has healed, you may need to use a harder splint or brace that has a hinge.

Arrange for someone to help with chores such as shopping, bathing, making meals, and housework for up to 6 weeks. You may want to make some changes around your home so it is easier for you to take care of yourself.

You will need to wait 6 to 8 weeks before you can drive. Your surgeon or physical therapist will tell you when it is OK.

You may be able to start using your elbow for heavier activities as soon as 12 weeks after surgery, but you may have some limit on how much you can lift or carry. Full recovery can take up to a year.

How much you can use your arm and when you can start using it will depend on the condition of your new elbow. Be sure to ask the surgeon what limits you may have.

The surgeon will recommend that you go to physical therapy to help you gain strength and use of your arm:

• If you have a splint, you may need to wait a few weeks to start therapy.
• Before starting physical therapy, ask your surgeon if you should begin to increase movement in your elbow by gently bending it back and forth. If you have pain or problems with your incision when you do this, you may be bending the elbow too much and need to stop.
• Reduce soreness after physical therapy by putting ice on the joint for 15 minutes. Wrap the ice in cloth. Do not put ice directly on the skin because this can cause frostbite.
• Please check with your doctor to see whether there is a weight limit for your new elbow replacement.

After the first week, you may be able to use your splint only while sleeping. Ask your surgeon if this is OK. You will need to avoid carrying anything or pulling items even when your splint is off.

By 6 weeks, you should be able to slowly increase daily activities to help make your elbow and arm stronger.

• Ask your surgeon or physical therapist how much weight you can lift.
• You may also need to do range-of-motion exercises for your shoulder and spine.

By 12 weeks, you should be able to lift more weight. Ask your surgeon or physical therapist what other activities you can do at this point. Your new elbow will likely have some limitations.

Make sure you know the proper way to use your elbow before you start any activity or move your arm for any reason. Ask your surgeon or physical therapist if you can:

• Lift things heavier than 5 to 15 pounds (2.5 to 6.8 kg) for the rest of your life
• Play golf or tennis, or throw objects (such as a ball) for the rest of your life
• Do any activities that make you lift your elbow over and over, such as shoveling or shooting a basketball
• Do jamming or pounding activities, such as hammering
• Do impact sports, such as boxing or football
• Do physical activities that need quick stop and start motions or twisting with your elbow
• Push or pull heavy objects

The stitches on your wound will be removed about 1 week after surgery. Keep the dressing (bandage) over your wound clean and dry. You may change the dressing every day if you like.

• Do not shower until after your follow-up appointment with your surgeon. Your surgeon will tell you when you can begin taking showers. When you do start showering again, let the water run over the incision, but do not let the water beat down on it. Do not scrub.
• Do not soak the wound in a bathtub, hot tub, or swimming pool for at least the first 3 weeks.

Pain is normal after elbow replacement surgery. It should get better over time.

Your surgeon will give you a prescription for pain medicine. After surgery, get it filled when you go home so that you have it when you need it. Take the pain medicine when you start having pain. Waiting too long to take it allows the pain to get worse than it should.

Ibuprofen or another anti-inflammatory medicine may also help. Ask your doctor what other medicines are safe to take with your pain medicine. Follow instructions exactly on how to take your medicines.

Narcotic pain medicine (codeine, hydrocodone, and oxycodone) can make you constipated. If you are taking them, drink plenty of fluids, and eat fruits and vegetables and other high-fiber foods to help keep your stools from becoming too hard.

Do not drink alcohol or drive if you are taking narcotic pain medicine. This medicine may make you too sleepy to drive safely.

Contact the surgeon or nurse if you have any of the following:

• Blood is soaking through your dressing and the bleeding does not stop when you put pressure on the area
• Pain does not go away after you take pain medicine
• You have swelling or pain in your arm
• Numbness or tingling in your fingers or hand
• Your hand or fingers look darker than normal or are cool to the touch
• You have redness, pain, swelling, or yellowish discharge from your incision
• You have a temperature higher than 101°F (38.3°C)
• Your new elbow joint feels loose, like it is moving around or shifting out of position

Total elbow arthroplasty - discharge; Endoprosthetic elbow replacement - discharge

Koehler SM, Ruch DS. Total elbow arthroplasty. In: Lee DH, Neviaser RJ, eds. Operative Techniques: Shoulder and Elbow Surgery. 2nd ed. Philadelphia, PA: Elsevier; 2019:chap 49.

Ozgur SE, Giangarra CE. The total elbow. In: Giangarra CE, Manske RC, eds. Clinical Orthopaedic Rehabilitation: A Team Approach. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 11.

Throckmorton TW. Shoulder and elbow arthroplasty. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 12.

Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.