There are different types of arthritis that affect the elbow joint: osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.
Also known as “wear and tear” arthritis, osteoarthritis (Fig 1) most commonly affects the dominant elbow of manual working men who present with pain and loss of movement of the elbow. The smooth cartilage of the shoulder becomes frayed, thinned and even worn away to eventually leave bone rubbing on bone.
Currently, the treatments are aimed at either controlling symptoms with activity modification, painkillers and injections or with surgery. Arthroscopic (keyhole surgery) or open debridement (Outerbridge-Kashiwagi or “OK” procedure) are more commonly offered but elbow replacement may be appropriate (see below).
Rheumatoid arthritis is a chronic inflammatory arthritis that tends to affect the small joints of the hands symmetrically. The elbows can be affected with pain and swelling of the joints.
There have been significant advances in the medical treatment of rheumatoid arthritis, often supervised by the Rheumatologists, but if symptoms are not controlled significant pain relief can be achieved by total elbow replacement surgery.
Arthritis can develop after injury to the elbow, such as fracture or dislocation. Activity modification, painkillers and injections can be helpful and if symptoms persist then surgery may be offered.
Elbow arthritis surgery
Arthroscopy (keyhole surgery)
Some patients with early arthritis of the elbow may benefit from debridement (clear out) of the joint.
The Outerbridge-Kashiwagi procedure is an open debridement (clear out) of the elbow, with removal of excess bone, loose bodies and inflamed tissue. This is aimed at improving pain and movement in the elbow.
Arthroplasty (replacement surgery)
Total elbow replacement surgery has declined over the years as the medicines for rheumatoid arthritis have improved and prevented patients’ symptoms from deteriorating to the point of requiring surgery. The incidence of elbow arthritis is significantly lower than that seen in the shoulder (and certainly the hips and knees) but total elbow replacement (Fig 2) in the right patient can be life changing.