Concierge orthopaedics · United Kingdom
Private elbow replacement in the UK, by a high-volume elbow surgeon.
Total elbow replacement is a low-volume UK procedure — around 1,500 a year, tracked by the National Joint Registry. We introduce you to a consultant elbow surgeon who does enough of them, and who will tell you honestly whether linked, unlinked or hemiarthroplasty is the right answer for your elbow.
Why patients choose us
- 01
A high-volume elbow surgeon, on the NJR
Total elbow replacement is a low-volume UK procedure — around 1,500 a year. We only introduce surgeons who do enough of them, and who submit outcomes to the National Joint Registry.
- 02
The right prosthesis for your elbow
Linked semi-constrained (Coonrad–Morrey, Nexel, Discovery) is not the only option. For the right patient an unlinked design (Kudo, Latitude) preserves bone. We say which fits before you commit.
- 03
Honest about the weight limit
A replaced elbow is not a normal elbow. Roughly 2.5kg repetitive, 5kg occasional — for life. If that is a dealbreaker, we say so upfront.
Indicative pricing
What a private elbow replacement costs in the UK.
Indicative ranges across our partner units. Send the details and we quote firm figures across two or three options.
In short
A primary total elbow replacement in our network: £15,000–£22,000, with a 2–4 night stay.
| Procedure | Indicative range | Typical duration | Stay / turnaround |
|---|---|---|---|
| Consultant elbow surgeon consultation | £250–£450 | 45 min | Report same day |
| Total elbow replacement (linked) | £16,000–£22,000 | 2 hrs theatre | 2–4 nights |
| Total elbow replacement (unlinked) | £15,000–£20,000 | 2 hrs theatre | 2–4 nights |
| Distal humeral hemiarthroplasty | £13,000–£18,000 | 90 min theatre | 1–3 nights |
| Revision elbow replacement | £22,000–£38,000 | 3–4 hrs | 3–5 nights |
| CT of elbow for templating | £450–£700 | 15 min | 24–48 hrs |
Prices vary by unit, by which surgeon does the case, by the implant chosen (linked, unlinked, hemi or a custom tumour prosthesis) and by length of stay. We come back with a firm quote within one working day.
The problem
A low-volume operation deserves a high-volume surgeon.
Only about 1,500 elbow replacements happen in the UK each year. Revision rates are higher than hip or knee — and the difference between a good and a mediocre outcome is largely about who does it and whether they honestly should.
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Told a replacement is the only option?
Sometimes arthrolysis, debridement or the Outerbridge–Kashiwagi procedure buy years first. We say so before you commit to an implant.
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Worried about the weight limit?
It is real — around 2.5kg repeatedly, 5kg occasionally, for life. If that is a dealbreaker for your job, we tell you upfront.
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Want to know your surgeon’s numbers?
Individual and unit outcomes go to the National Joint Registry. We introduce you to surgeons who publish theirs.
The journey
From enquiry to hinged brace — what happens, in order.
One concierge from first message to your six-week review, with the physio team looped in from day one.
Phase 1 · Before your operation
Concierge, off-stage for you
Phase 2 · On the day
Admission and theatre
Phase 3 · After
Brace, physio, review
- 01
Before
You tell us what is going on
A short, confidential form. Diagnosis, prior surgery, medications, and what you can still do with the elbow.
- 02
Before
We come back with a recommendation
Within one working day: whether a replacement is right, which prosthesis, and whether arthrolysis or debridement should come first.
- 03
Before
Pre-assessment and imaging review
Recent radiographs and often a CT are reviewed. Rheumatology, DMARDs and clopidogrel are coordinated with the team.
- 04
On the day
Admission and anaesthetic
GA with a supraclavicular or interscalene regional block for post-op pain. Antibiotic and VTE prophylaxis on the ward.
- 05
On the day
The operation itself
90 to 150 minutes. Posterior approach, ulnar nerve identified and usually transposed, cemented humeral and ulnar components.
- 06
On the day
Two to four nights in
A well-padded dressing in mid-flexion, immediate gentle motion, and physio starts on day one.
- 07
After
Six weeks in a hinged brace
Physio-led range-of-motion, hinged elbow brace for six weeks, and a lifetime weight limit we go through carefully at your review.
Typical end-to-end: 3–4 weeks from enquiry to operation. Hinged brace: 6 weeks. Full functional recovery: 3–6 months.
When it helps
When an elbow replacement is the right step.
The indications we see most, one situation where a replacement is usually the wrong answer, and one red flag that means an emergency rather than an appointment.
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Rheumatoid arthritis
Historically the commonest indication — a painful, unstable, destroyed elbow in inflammatory disease responds well to a linked prosthesis.
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Post-traumatic osteoarthritis
A stiff, painful elbow after an old fracture or dislocation — arthroplasty when arthrolysis and debridement are no longer enough.
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Distal humeral non-union or malunion
A distal humeral fracture that failed to heal, or healed in a poor position, in a patient with modest demands.
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Comminuted distal humeral fracture (>65)
In an older patient with poor bone stock, primary replacement — total or hemiarthroplasty with Latitude EV — often beats ORIF.
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Tumour reconstruction
Segmental replacement after resection of a distal humeral or proximal ulnar tumour, usually with a custom or modular linked implant.
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Failed prior elbow surgery
Salvage after failed radial head replacement, interposition arthroplasty or ORIF — carefully staged, with revision principles.
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Not usually — primary OA in a young patient
A young manual worker with primary elbow OA is rarely a replacement candidate. Arthrolysis, debridement or the Outerbridge–Kashiwagi procedure come first.
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Red flag: prosthetic joint infection
A hot, swollen, discharging elbow after replacement is an emergency. Same-day A&E and orthopaedic review — do not wait for a routine clinic slot.
Prosthesis options
Linked, unlinked, or hemi — and sometimes none of the above.
What each option involves — and which fits which elbow. If arthrolysis or debridement is the smarter first step, we say so.
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Coonrad–Morrey (linked)
The reference linked semi-constrained device — a loose hinge that allows a few degrees of varus–valgus laxity. The default for rheumatoid and revision cases.
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Nexel (linked)
A modern linked design with a vitamin-E polyethylene bushing intended to reduce wear. Similar indications to Coonrad–Morrey.
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Discovery (linked)
A UK-common linked semi-constrained implant with modular options, used for RA and post-traumatic cases across BESS surgeons.
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Kudo (unlinked)
An unlinked resurfacing design — preserves bone and ligaments, but needs a competent ligament sleeve. Suits selected rheumatoid elbows.
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Latitude (unlinked/convertible)
A convertible system — starts unlinked and can be converted to linked at revision without removing well-fixed components.
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Latitude EV hemiarthroplasty
Distal humeral hemiarthroplasty for acute comminuted distal humeral fracture in the elderly — replaces the humerus only, preserving the native ulna and radial head.
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Arthrolysis or debridement first
For stiff post-traumatic elbows in younger patients, open or arthroscopic arthrolysis and debridement often buy years before a replacement is needed.
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Consultation only
An honest second opinion — whether a replacement is the right step at all, and if so, which prosthesis fits your elbow and your life.
Our vetted UK network
A small panel of elbow surgeons, we picked them.
BESS-faculty consultant elbow surgeons across London, the South East and the Midlands. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every elbow surgeon in our network.
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Consultant elbow surgeons on the British Elbow and Shoulder Society (BESS) faculty
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Individual and unit outcomes submitted to the National Joint Registry (NJR)
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Adequate annual volume of primary and revision elbow arthroplasty
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Access to on-site rheumatology, microbiology and hand-therapy-led rehabilitation
Safety and recovery
What to expect afterwards — honestly.
Elbow replacement is a good operation in the right patient. The things worth planning are the lifetime weight limit, the six-week brace, and knowing what is normal — and what is not.
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Lifetime weight limit — strict
Roughly 2.5kg repeatedly and 5kg occasionally, for life. Ignore it and the components loosen sooner. We go through what that means for your job and hobbies.
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NJR outcomes — honest numbers
From the National Joint Registry, revision at 5 years sits around 5%, and at 10 years around 10–15%. Higher than hip or knee replacement, which is why patient selection matters.
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Infection is the worst complication
Deep prosthetic joint infection runs at roughly 2–5% — higher than hip or knee. Antibiotic prophylaxis, careful skin, and vigilant follow-up all matter.
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Ulnar nerve is always at risk
The ulnar nerve is identified and usually transposed anteriorly. A transient neuropraxia is common; a persistent deficit is uncommon but real.
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Triceps insufficiency
The triceps-off approach gives the surgeon more access; the triceps-on approach protects extension strength. Both are legitimate — the surgeon chooses per case.
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Aseptic loosening and polyethylene wear
Over time the polyethylene bushing wears and the cement–bone interface can loosen. Regular radiographs pick it up before it becomes symptomatic.
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Periprosthetic fracture
A fracture around the implant, usually after a fall. Prevention is falls-avoidance and honouring the weight limit; treatment is often complex revision surgery.
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Revision options are limited
Elbow revision is technically harder than hip or knee revision, with fewer implants available. This is why we push arthrolysis or debridement first in younger patients.
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Red flags
A hot, swollen, discharging wound, a sudden loss of extension, or a new fever after surgery are not normal — call the on-call team or attend A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever prosthesis was used, the note the surgeon sends you — and the NJR record — keeps to the same shape.
A quiet reminder
Orthopaedic language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note and your NJR entry before your review, just ask.
- 01 Header
Indication and prosthesis chosen
Why the replacement was done — rheumatoid, post-traumatic, fracture, tumour — and which implant (linked or unlinked, brand and size) was used.
- 02 Technique
Approach, ulnar nerve, cementation
Triceps-on or triceps-off, whether the ulnar nerve was transposed, cement used, and any bone grafting recorded on the op note.
- 03 Findings
Intra-operative findings and stability
Bone quality, ligament status, joint stability tested at the end of the case, and any incidental findings sent to the NJR.
- 04 Impression
Rehab plan, weight limit, review
Read this first: hinged brace protocol, physio milestones, the weight limit, and when you will be seen back for radiographs.
Recognised by major UK insurers
Elbow replacement is usually covered by UK health insurers when medically indicated. Pre-authorisation numbers and implant approvals are confirmed before we book.
Frequently asked
Everything we get asked about elbow replacement.
Straight answers on prosthesis choice, the weight limit, NJR outcomes and recovery.
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What is a total elbow replacement?
A total elbow replacement (TER) removes the arthritic surfaces of the humerus and ulna and replaces them with metal and polyethylene components, usually cemented. Most are linked semi-constrained designs (Coonrad–Morrey, Nexel, Discovery); some are unlinked (Kudo, Latitude). The operation is done via a posterior approach and the ulnar nerve is usually transposed.
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Who needs an elbow replacement?
Typical candidates are patients with rheumatoid arthritis, post-traumatic osteoarthritis, a distal humeral non-union or malunion, tumour reconstruction, or an elderly patient (over 65) with a comminuted distal humeral fracture where fixation is unlikely to succeed. Young patients with primary elbow OA are rarely candidates — arthrolysis and debridement come first.
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How is a linked prosthesis different from an unlinked one?
A linked semi-constrained implant (Coonrad–Morrey, Nexel, Discovery) has a loose hinge holding the humeral and ulnar parts together — the ligaments do not have to work. An unlinked implant (Kudo, Latitude) is a resurfacing that relies on intact ligaments and preserves more bone. Linked designs suit rheumatoid and unstable elbows; unlinked designs suit selected patients with a competent ligament sleeve.
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What is the weight limit after an elbow replacement?
Roughly 2.5kg for repetitive activity and 5kg for occasional lifting, for the rest of your life. This is strict — the implant is not designed for heavy loading and the components loosen if you exceed it. We go through what that means for your job, gardening, and holding grandchildren.
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What are the risks and how often does it need revising?
The main risks are infection (2–5%), ulnar neuropathy, triceps insufficiency, periprosthetic fracture, aseptic loosening, polyethylene wear and instability. National Joint Registry data show revision at around 5% at five years and 10–15% at ten years — higher than hip or knee replacement, and one reason patient selection matters so much.
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What is a distal humeral hemiarthroplasty?
A distal humeral hemiarthroplasty (usually with the Latitude EV) replaces only the humeral side of the joint, preserving the native ulna and radial head. It is used in acute comminuted distal humeral fractures in elderly patients where internal fixation is unlikely to work but a total replacement is not warranted.
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What is the recovery like?
You will spend 2–4 nights in hospital. A well-padded dressing holds the elbow in mid-flexion and physio starts on day one. A hinged elbow brace is worn for six weeks with physio-led range-of-motion work. Most people are driving again at 6–8 weeks and using the elbow normally (within the weight limit) at three months.
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How much does a private elbow replacement cost in the UK?
A primary total elbow replacement runs £15,000–£22,000 self-pay, including the surgeon, anaesthetist, implants, theatre, ward stay and follow-up. A distal humeral hemiarthroplasty is £13,000–£18,000. Revision surgery is £22,000–£38,000. We confirm a firm figure within one working day.
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When should I be seen urgently?
A hot, swollen or discharging wound, a sudden new fever, a sudden loss of extension or a fall onto the replaced elbow are all reasons to seek same-day medical help. Prosthetic joint infection needs urgent orthopaedic assessment — not a routine clinic slot.
Related treatments
Looking for something else?
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Elbow arthrolysis
Release of a stiff elbow — often the smarter first step in younger patients.
Learn more -
Open elbow debridement
Removes osteophytes and loose bodies in post-traumatic OA.
Learn more -
Elbow physiotherapy
Hand-therapy-led rehab before, and after, surgery.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more