Elbow joint is hinge joint between the arm bone (humerus) and forearm bones (radius and ulna). It comprises of ulno-humeral joint, radio-capitellar joint, and proximal radio-ulnar joint. It is supported by important ligaments on both sides, lateral collateral ligament and medial collateral ligament.

It is mostly affected by trauma, sports injuries, fractures, tendon tears, nerve compression, and arthritis. When affected, it causes pain and restricted movement of the joint, limiting overall upper limb function. When conservative treatments—like physical therapy, bracing, medication, or injections—fail, surgical intervention may be recommended such as repair of the torn ligaments or tendon, nerve decompression, arthroscopic debridement, fixation of fractures, or elbow replacement. 

Preoperative Process

• Imaging: X-rays, MRI, or CT scans to determine the extent of damage.
• Conservative Management First: Physical therapy, NSAIDs, bracing, and steroid injections are usually tried before surgery.
• Informed Consent: Includes risks, benefits, recovery timeline, and realistic expectations.
• Pre-op Physical Therapy: Sometimes recommended to improve baseline function. 

The Procedure

• Setting: Most procedures are outpatient unless a major reconstruction or replacement is performed.
• Anaesthesia: General or regional block (brachial plexus block).
• Surgical Duration: Varies—30 minutes (simple arthroscopy) to 2+ hours (replacement or fracture repair).
• Instruments: Arthroscope (minimally invasive), or open surgical tools for more complex repairs. 

Postoperative Recovery

1. Immediate Recovery

• Splinting or bracing may be required.
• Pain managed with oral medications or regional anaesthesia.
• Ice and elevation help reduce swelling.

2. Rehabilitation

• Phase 1 (0–2 weeks): Rest, protect joint, manage pain and swelling.
• Phase 2 (2–6 weeks): Begin gentle range-of-motion exercises.
• Phase 3 (6–12+ weeks): Progressive strengthening and return to function.

3. Return to Activity

• Desk work: 1–3 weeks depending on surgery type.
• Manual labour: 3–6 months.
• Sports: 4–9 months (especially throwing sports). 

Benefits of Elbow Surgery

• Significant pain relief.
• Improved joint mobility and strength.
• Restored nerve function (in cases of compression).
• Correction of deformity or instability.
• Return to daily activities or athletic performance.
• Prevention of long-term joint degeneration. 

Risks and Complications

• Infection.
• Nerve injury (especially ulnar or radial nerve).
• Persistent stiffness or loss of motion.
• Chronic pain or complex regional pain syndrome (CRPS).
• Hardware failure or loosening.
• Blood clots (less common in upper extremity).
• Failure of tendon or ligament repair.
• Need for revision surgery. 

Elbow surgery can be life-changing for patients with chronic pain, instability, or injury that limits arm use. While outcomes are generally positive, patient motivation, adherence to rehab, and the experience of the surgeon play crucial roles in success. Not every elbow condition requires surgery, but for those who do, advances in surgical techniques—especially minimally invasive approaches—have significantly improved results and shortened recovery times.