Arthritis of the elbow is the result of damage or wear to the cartilage surfaces on the ends of the bones that join in the elbow joint. When normal, these bone surfaces move smoothly together. Cartilage in arthritic elbows is damaged and worn, with common symptoms of pain and loss of range of motion, although both do not necessarily occur at the same time.
Patients usually complain of “grating” or “locking” in the elbow. The grating is caused by the rough and irregular surfaces in the joint that result from cartilage damage or wear. Locking occurs when fragments of cartilage or bone lodge in the joint and impede motion. As arthritis progresses, joints may also swell and, in advanced stages, cause numbness in the ring and pinky fingers.
One of the leading cause of arthritis of the elbow is rheumatoid arthritis, a long-term disease that leads to inflammation of the joints and surrounding tissues. The condition is also caused by previous elbow injury, such as a fracture or a dislocation, or the result of degeneration of cartilage in the elbow joint from aging or long term overwork. Elbow arthritis without previous injury is more common in men. While the condition typically occurs in patients age 50 or older, some can experience symptoms earlier.
We usually diagnose arthritis of the elbow based on symptoms and X-rays which show the arthritic changes. Advanced diagnostic imaging, such as CT (computed tomography) or MRI (magnetic resonance imaging), is typically not needed to diagnose arthritis of the elbow.
We commonly treat early-stage arthritis of the elbow with pain medication, physical therapy and by modifying activity. Corticosteroid injections can provide significant pain relief. An alternative to steroids is viscosupplementation which uses hyaluronic acid to increase the fluid to cushion the diseased cartilage in the joint.
When nonsurgical treatment cannot control symptoms, surgery may be needed. If wear or damage to the elbow cartilage is limited, arthroscopy offers a minimally invasive treatment option. The procedure removes loose fragments or inflammatory/degenerative tissue in the joint while also smoothing out irregular surfaces. By using multiple small incisions, we are able to do this as an outpatient procedure with relatively rapid recovery for most patients.
Joint replacement surgery becomes necessary when the joint surface has worn away completely and no other option can provide relief. There are several types of elbow joint replacement available.
In appropriately-selected patients the improvement in pain and function can be dramatic. With an experienced surgeon, the results for elbow joint replacement are typically as good as those for hip replacement and knee replacement. Young patients or those too active for prosthetic joint replacement can benefit from other surgical options. If loss of motion is the primary symptom, we can release the contracture and smooth the joint surface. Also, a new surface can be made from the patient’s tissues.