Elbow arthritis can be a very debilitating condition. Not only does it cause pain, it can also significantly reduce the range of movement of the elbow and this can limit a patient’s ability to complete normal day-to-day tasks.
Causes
Many cases of elbow arthritis are the result of previous trauma. A fracture that extends into the joint surface can result in damage to the cartilage and alter wear patterns within the joint.
There are several components to the elbow joint. The main articulation between the humerus (the bone in the upper arm) and the ulna (one of the forearm bones) acts as a hinge joint. There is a further joint between the radial head and the humerus through which the forearm rotates.
Fractures of the radial head can affect both flexion and extension of the elbow as well as forearm rotation. Fractures around the elbow can be associated with ligament injuries. If there has been disruption of the normal ligamentous support to the elbow, this can produce instability of the joint which may result in early degenerative change.
Treatment
Treatment options for elbow arthritis will depend on the symptoms that the patient is experiencing. Some patients may present with bony spurs that cause local pain and irritation.
Sometimes fragments of bone can break free and act as loose bodies within the elbow joint. These can sometimes be dealt with by an elbow arthroscopy which allows removal of loose bodies through a keyhole procedure.
In some cases, a release of the capsular structures around the elbow may allow an improvement in the range of movement of the joint.
On occasions, the radial head can be replaced with a prosthesis or in some instances it may be excised. The main hinge joint in the elbow can be replaced in very limited circumstances.
In most cases of elbow arthritis, initial management focuses on pain relief. This may necessitate long-term simple analgesia to control the pain or anti-inflammatory medication to reduce swelling and soft tissue thickening.
Medical treatment for inflammatory arthritis such as rheumatoid disease has improved greatly in recent years. Fewer cases of destructive disease are now seen.