The elbow, like any other joint in the body, is covered with cartilage that allows for smooth motion as the joint moves. Although much less common that knee, hip, or shoulder degenerative joint disease, the elbow can lose this cartilage and develop arthritis. When this happens, straightening and bending the elbow can be painful and the elbow can lose some of its range of motion. Additionally, bone spurs (osteophytes) can form around the elbow joint and cause a type of impingement pain as the joint tries to move past them.
What are the most common symptoms associated with elbow arthritis?
The most common symptom is typically pain in the elbow as it fully bends or straightens. In addition, people may also notice that their elbow motion is not as full as it once was and may have difficulty bringing their hands to their mouth or holding the elbow completely straight. Also, patients may report clicking, catching, or popping with elbow motion.
Who typically develops elbow arthritis?
Elbow arthritis is relatively uncommon, but may occur in any person. Typically, patients who have had a traumatic injury to the elbow in the past or who perform repetitive, heavy labor may be at a higher risk for developing elbow arthritis. Also, patients with a history of arthritis, especially rheumatoid arthritis, may be at risk for developing arthritis of the elbow joint.
How is elbow arthritis treated?
The initial treatment for elbow arthritis is aimed at relieving pain and improving motion. This consists of anti-inflammatory medications, topical pain creams, physical therapy, and consideration of a steroid injection. Patients with continued symptoms despite treatment may be candidates for a procedure called an osteocapsular debridement (OCD). The goal of this procedure is to clean out the elbow joint, remove osteophytes, and release scar and tight, soft tissues. Typically, this procedure will improve the elbow range of motion and for patients with impingement pain from osteophytes, can considerably improve pain. This procedure may be done using an open approach or with use of an arthroscope depending on the extent of the disease process. The benefit of this procedure is that there are no long-term restrictions afterward. The last option for the treatment of elbow arthritis is replacement of the elbow joint, or total elbow arthroplasty, in which the arthritic joint is removed and replaced with metal and plastic.
Who is a candidate for total elbow arthroplasty (TEA)?
TEA typically provides patients with elbow arthritis excellent pain relief and improved elbow stability. This procedure places a metal implant into the humerus and ulna and secures these with bone cement. These components are then linked to allow for smooth elbow motion and stability. However, because these components (implants) are connected, there is a risk of loosening of the bone cement as a result of weight bearing forces. Therefore, TEA is typically reserved for people over 70 years of age or those who do not bear much weight with the upper arm and elbow. After a TEA, a patient will have a restriction for life of not being able to lift more than five pounds with that arm.
To learn more about elbow stiffness and arthritis, or to schedule an appointment with one of our specialty-trained elbow doctors at Western Orthopaedics, please call (303) 321-1333.