Elbow Arthritis
Osteoarthritis, Post-Traumatic & Inflammatory Arthritis
Comprehensive guide to elbow arthritis - causes, treatment options, and surgical solutions
Understanding Elbow Arthritis
Unlike hip and knee joints, the elbow is not a weight-bearing joint, making primary osteoarthritis less common. However, elbow arthritis significantly impacts daily activities as the joint is essential for hand positioning and function.
Affects heavy laborers, throwing athletes
Typically middle-aged males
Posterior compartment involvement
Most common type of elbow arthritis
Follows fractures/dislocations
Can occur at any age
Rheumatoid arthritis most common
Bilateral involvement typical
Affects synovium primarily
Symptoms & Diagnosis
Common Symptoms
Imaging
X-rays
Show osteophytes (bone spurs), loose bodies, joint space narrowing, olecranon fossa osteophytes
CT Scan
Better defines bone anatomy, useful for surgical planning and identifying loose bodies
MRI
Evaluates soft tissues, cartilage status, and inflammatory changes in RA
Treatment Options
Activity Modification
Avoid repetitive heavy loading, modify work and recreational activities
Medications
NSAIDs for pain and inflammation; DMARDs for inflammatory arthritis
Physical Therapy
Maintain range of motion, strengthen supporting muscles
Injections
Corticosteroid injections for temporary relief; hyaluronic acid may help some patients
Arthroscopic Debridement
Minimally invasive removal of loose bodies, osteophytes, and inflamed synovium. Good for early-moderate OA.
Outerbridge-Kashiwagi (OK) Procedure
Ulnohumeral arthroplasty - fenestration through olecranon fossa for debridement. Effective for posterior compartment OA in younger, active patients.
Open Debridement (Column Procedure)
Morrey column procedure for extensive arthritis - removal of osteophytes from medial and lateral columns with capsular release.
Total Elbow Replacement (TEA)
Reserved for severe arthritis, particularly rheumatoid. Best for lower-demand, older patients. Linked or unlinked designs available.
Interposition Arthroplasty
Soft tissue (fascia, Achilles allograft) placed between joint surfaces. Option for younger patients not suitable for TEA.
Evidence & References
• Morrey BF. Primary degenerative arthritis of the elbow: Treatment by ulnohumeral arthroplasty. JBJS 1992
• Kashiwagi D. Intra-articular changes of the osteoarthritic elbow. J Jpn Orthop Assoc 1978
• Gramstad GD, Galatz LM. Management of elbow osteoarthritis. JBJS Am 2006
• Yeoh D, Tourret L. Total elbow arthroplasty for primary osteoarthritis of the elbow: a review. Hand Surg 2015
Last Updated: January 2025 | Content reviewed by Dr. Deepthi Nandan Reddy, FRCS (Ortho)