What is it?
This is a degenerative condition of the elbow joint, whereby the cartilage becomes damaged or is worn away over time. Arthritis in the elbow is an unusual, due to its highly congruent joint surface and robust supportive ligaments.
Why does it occur?
The majority of patients with elbow arthritis have previously sustained damage to the joint, either by fracture or dislocation. The joint surface becomes uneven and new bone can form irregularly (osteophytes), which restrict movement. Some patients suffer as a result of activity which overloads or overuses the joint, causing degenerative wear and tear.
What are the symptoms?
Elbow arthritis is most commonly associated with pain, stiffness and swelling, particularly after periods of increased activity. Some patients experience restricted movement, or a creaking sensation when trying to use the joint. If loose bodies (bits of bone debris) are present in the joint, patients may experience elbow ‘locking’, which can be resolved by shaking the affected arm, displacing the fragments.
How is it diagnosed?
Your consultant will ask you a series of questions to establish whether you have any risk factors for arthritis, and discuss with you the severity of your symptoms. They will also carry out a detailed examination of your joints. In most cases the diagnosis is confirmed with an x-ray, but occasionally further tests or scans may be required.
How is it treated?
The best course of treatment for elbow arthritis depends the part of the joint affected, your general health, your activity levels, and the severity of your symptoms. Conservative options would almost always be tried before surgical options are considered. There are three articulations within the elbow, and your consultant should identify exactly which aspect of the joint is affected prior to initiating treatment. There could be a number of other factors contributing to arthritis, and these also need to be eliminated before treatment is prescribed.
These options might include modifications to your lifestyle combined with some painkilling medications. Physiotherapy in the early stages can also help to delay the onset and severity of any stiffness, and steroid injections can be beneficial in reducing inflammation. Alternatively, a course of hyaluronic acid injections acts to lubricate and cushion the joint and thereby reduce pain.
In some cases, arthroscopy, or keyhole surgery, may be considered as the best long-term solution. This involves making multiple small incisions around the elbow joint and using instruments to remove any loose bodies and smooth the joint surfaces. Eliminating any bony spurs (osteophytes) that may be impinging local soft tissues is also possible with keyhole surgery.
Where the elbow joint surface has worn away completely, your consultant will talk to you about a joint replacement. If you are deemed unsuitable for a whole joint replacement, due to your age or desired activity levels, alternative surgical options may be explored. These might include a release of the contracted joint capsule, or replacing the joint surface using the patient’s own body tissue.
The best and most appropriate option for you will depend on your specific case, and all the options, risks and benefits will be discussed during your consultation.
The One Orthopaedics team specialists
Consultant Orthopaedic Specialist FRCS (Tr & Orth)