Elbow replacement in Iran: all you need to know

Elbow joint replacement surgery, also referred to as elbow arthroplasty and often shortened to elbow replacement, is a complicated orthopedic surgery in which the natural elbow joint is replaced with an artificial joint made from two implants attaching to the upper and lower arm bones with a hinge between them (total elbow replacement) or just one piece of prosthesis attaching to the head of one of the arm bones (partial elbow replacement).

Although not as common as knee replacement and hip replacement, elbow replacement surgery is offered at some private and governmental hospitals in Iran. The low cost of orthopedic surgery in Iran has made the country a good destination for elbow arthroplasty candidates.

It is no exaggeration to say that one can have an elbow surgery in Iran at less than 30% of the cost they would have to pay in many countries. This article first touches on the different aspects of elbow replacement surgery in general and then provides some information on elbow joint replacement in Iran in particular.

Who needs an elbow replacement?

Candidates for elbow joint replacement surgery are typically people with elbow pain and arm movement problems caused by traumatic fractures or rheumatoid arthritis.

Older adults are more likely to have to undergo an elbow arthroplasty due to their greater likelihood of breaking a bone from a fall. Fracture of the lower part of the upper arm bone, called the distal humerus, sometimes is so severe that other treatment options don’t work and the individual needs to undergo an elbow replacement surgery. Distal humerus fractures almost always require surgery and other options other than elbow replacement do not yield the desired result.

Other elbow arthroplasty candidates are those with different types of arthritis, including rheumatoid arthritis and psoriatic arthritis. The improvements in non-surgical treatment options for these group, however, have led to fewer people having to get elbow replacement surgery these days.

Though not a common condition, osteoarthritis in the elbow is another reason people having to get their elbow joint replaced.

How is an elbow replacement performed?

It takes around 2-4 hours for a surgeon to carry out an elbow replacement operation. The surgery is performed in an operating room in a hospital, where you first receive anesthetic to feel no pain during the operation and then the surgeon makes an incision at the back of the elbow to access the arm bone and joint.

The surgeon then removes any scar tissue, bone spurs, and cartilage residue. Next, he/she places the elbow joint prosthetic devices between the bones of upper and lower arms (humerus and ulna) and attaches them to the bones. Finally, the surgeon closes the incision with stitches or staples and apply a bandage to your elbow. Some surgeons place splints around your arm to keep the bone stable while it heals.

You will be required to stay in the hospital for up to 4 days after an elbow replacement surgery. During this time, you receive special medical care until you are stable enough to get discharged from the hospital and go home.

Types of elbow replacement

In terms of the extensiveness of the surgery, an elbow replacement can be partial or total.

Partial elbow replacement

A partial elbow arthroplasty is a treatment option for elbow joint damages, in which only one part of the joint is replaced with an orthopedic prosthesis. This elbow surgery is technically called Hemiarthroplasty.

Total elbow replacement

A total elbow arthroplasty involves replacing all parts of the elbow joint with prostheses. In this procedure, the cartilage of the ends of the three arm bones (the distal end of the humerus in the upper arm and the proximal ends of the ulna and radius in the forearm) is removed and replaced with prosthetic components that together function similar to your natural elbow joint.

Types of elbow prostheses

Elbow joint prosthetic devices come in two main types.

Linked prosthesis

This joint prosthesis is a kind of loose hinge all parts of which are connected. One advantage of linked joint prostheses is that they provide good stability. However, the stresses of movements may result in the loosening of the prosthesis.

Unlinked prosthesis

These joint prostheses have separate pieces each attaching to the end of one bone. Candidates for unlinked elbow replacements should undergo a thorough evaluation of elbow stability, including bone stock, collateral ligament integrity, and periarticular muscle function. If these criteria aren’t met, the procedure can fail and the risk of elbow dislocation increases.

Preparing for elbow replacement surgery

• You need to inform your doctor about any medical condition you may have, such as diabetes and high blood pressure. Your doctor also asks about medicines you currently take, so be sure to have the generic names of your medications and their dosages to show to your doctor a few weeks before surgery.
• If you take aspirin and other anti-inflammatory medications, you should stop them a few weeks before surgery. Consult with your doctor about this so that he/she prescribes an alternative for you, such as acetaminophen.
• You have to stop smoking and drinking alcohol a few weeks before surgery as they hinder healing and increase bleeding.
• You need to finish any dental work before considering an elbow replacement because the germs in your mouth may enter the bloodstream and cause infection in the joint.
• You may need blood during elbow replacement surgery, so you can either donate your own blood in advance to be used later during the operation. If you want to use blood from other donors for transfusion, the surgeon may place an order with the blood bank.
• Make sure to prepare your questions to ask your surgeon before surgery. Questions can range from how to prepare for surgery to dietary instructions for post-operative phase.
• You need to arrange for a friend or close relative to be available for a few weeks after surgery to help you with daily activities, including bathing, using the toilet, housework, shopping, and laundry. If you are traveling abroad for an elbow replacement, take someone with you and arrange a hotel that provide special services to surgical patients.
• Prepare your home for recovery by storing frequently used items and foods, organizing frequently used items in easy-to-access places, and checking the safety of your home to prevent tripping and falls. You may need to place a non-slip mat in your bathroom.
• Check with your doctor to see when you are supposed to start fasting before surgery, typically, surgeons ask patients to not eat or drink anything after the midnight before surgery.

Elbow replacement recovery and post-op care

While in the hospital, your physical therapist prescribes a rehabilitation program than include exercises to relax muscles. He/she also instructs you other at-home rehabilitation exercises for your recovery period after elbow surgery.

The bandages and sutures are usually removed before being discharged from the hospital, but your elbow remains swollen and tender for several weeks.

Sine elbow surgery is a major operation, it takes time to fully recover from it. You need to take strong pain medications for 2-3 weeks after surgery. Also, getting used to the new elbow takes a few weeks. You shouldn’t lift anything heavier than a cup of coffee for some 6 weeks after surgery.

It is vital that you adhere to your doctor’s instructions for proper recovery from your elbow replacement surgery. Be sure to have you’re your questions cleared up by your doctor before leaving the hospital.

Risks and complications of elbow replacement

No surgery is completely risk-free and elbow replacement is no exception. The most common risks of elbow replacement surgery are:

• infection
• nerve and blood injury
• wearing or loosening of the prosthesis
• Allergic reaction to the prosthesis
• Joint instability
• Bleeding and blood clot
• Pain
• Anesthesia risks

Choosing an experienced surgeon will ensure that the chance of developing complications after your elbow surgery will be as small as possible.

Why have my elbow replacement surgery in Iran?

As said at the beginning of this article, Iranian hospitals offer cost-effective orthopedic treatment to foreign patients. Thanks to the well-trained orthopedic surgeons and modern medical facilities, coupled with affordable prices, patients from different countries opt for Iran to have their joint replacement surgery done.

Since an orthopedic surgery abroad, including an elbow replacement, involve some inconveniences, especially given that you need special care after surgery, we at AriaMedTour are working hard to facilitate  the whole process, from arranging the surgery appointment, accommodations, and private transfer, to post-up care until flying back home and online follow-up after leaving Iran.

If you are looking for options for your elbow replacement surgery, feel free to contact us for a consultation and price quote. Our patient coordinators are available 24/7 to provide you with details.

Elbow replacement cost in Iran

Elbow replacement surgery prices in Iran vary depending on the reputation of the surgeon, the type of prosthesis used, and whether it is a partial or total elbow replacement.

All in all, with an elbow replacement in Iran you can save up to 70% even if you add your travel expenses. A typical elbow replacement surgery in Iran costs between $4000 and $7000 with an average of $5000. This is while the same procedure would cost between $35000 and $40000 in America without insurance.