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Arthritis of the Elbow

Arthritis is a loss of cartilage in the joint, which results in inflammation and the generation of bone spurs and loose bodies. Though less commonly seen in the elbow than in weight bearing joints of the lower extremity (e.g. the hip and knee), arthritis of the elbow can be every bit as disabling, affecting the ability to position the hand out in front of the body or bringing the hand to the face and mouth.

Signs and Symptoms of Elbow Arthritis

  • Pain in the elbow, usually at maximum extension or flexion
  • Loss of motion in the elbow
  • Clicking, locking, or other noises coming from the elbow during motion
  • Swelling of the elbow

Causes of Elbow Arthritis

Arthritis can affect all ages but is most commonly seen in people aged over 40 years. The most common cause is wear and tear such as with prolonged heavy labor or weight training. A family history of arthritis or prior history of injuries such as fractures and dislocations increase the odds of developing elbow arthritis.

Types of Arthritis

There are several types of arthritis, the most common being:

  • Osteoarthritis or degenerative joint disease is the most common type of arthritis that affects the elderly. It causes the cartilage, the tissue that cushions and protects the ends of bones in a joint, to wear off, causing painful rubbing of the bones.
  • Rheumatoid arthritis is an autoimmune disease in which the body’s immune system attacks healthy joints, tissues, and organs. It can cause pain, stiffness, swelling, deformity, and loss of function in the joints. This condition may occur at a younger age than osteoarthritis
  • Post-traumatic arthritis develops after an injury to the elbow (fracture, severe sprain, ligament injury). The condition may develop months to years after the initial injury.
  • Psoriatic arthritis is an uncommon condition which behaves similar to rheumatoid arthritis and is associated with psoriasis, a scaling skin disorder affecting the face, scalp, knees and elbow.

Diagnosis of Elbow Arthritis

Arthritis in the elbow is diagnosed by a thorough physical examination and X-ray. A CT scan may be used as a preoperative tool for 3-dimensional localization of bone spurs and loose bodies.

Treatment Options for Elbow Arthritis

Treatment begins by decreasing the amount of lifting and heavy activity on the elbow. Regular application of warm packs to the elbow and nonsteroidal antiinflammatory medications are useful. Cortisone injections may be considered if the pain is debilitating despite the above treatments. Surgery may be considered if non-surgical treatment fails to offer relief. Elbow arthroscopy is minimally invasive, very effective and is the treatment of choice unless the patient has severe arthritis. Total elbow replacement (arthroplasty) may be considered in severe cases. This is a procedure in which the ends of the humerus and ulna are removed, then replaced by prosthetic hinge components to restore pain free motion. Total elbow arthroplasty is not nearly as durable as total hip or knee arthroplasty and should only be offered under very careful consideration and discussion with a surgeon who is experienced in all manner of treatment of elbow arthritis.

  • NASS
  • AAOS
  • American Association of Hip and Knee Surgeons (AAHKS)
  • Tufts University School of Medicine
  • Newton-Wellesley Hospital