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Osteoarthritis of the elbow

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Written by Garotta Lorenzo   

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Like all joints, the elbow can suffer from osteoarthritis. Many factors are responsible for degenerative change: post traumatic stress after articular fracture, systemic diseases (rheumatoid arthritis, psoriatic...), in athletes who practice body building ...

Once again, arthroscopy has helped to change the  approach to osteoarthritis: arthroscopic osteophytes removal often achieves good results, while prosthetic treatment is reserved for only a few selected patients. 

Symptoms, clinical examination and radiology.
Osteoarthritis of the elbow is often well tolerated: limitation of mobility, which is the first symptom, may be modest. But it is the pain that can disturb the patient during daily activities;  especially at the "end of movement" - pain occurring in late extension or maximum elbow flexion.
Clinical examination found a lack of extension associated with posterior  pain.  This is often accompanied by tingling at the 4th and 5th finger, typical of an ulnar nerve pain.
Xrays show, in advanced cases, joint pain associated with the presence of intra-articular (loose) body . In the initial stages, a CT scan is the best examination method to show up coronoid  and olecranon osteophytes and  small loose bodies in the anterior and posterior fossa.

 

Arthroscopic surgical technique
Arthroscopy has changed the treatment of osteoarthritis: the humeral-ulnar arthroplasty which allows for excellent results in open surgery, can also be performed arthroscopically. 
The principle of this surgical procedure is the removal of loose bodies and osteophytes (bone spurs) typical of osteoarthritis which cause the pain "at the end of movements." 

If the arthritis is too advanced, sometimes interposition arthroplasty may be proposed before a prosthetic replacement.
Elbow prosthesis should be reserved for the elderly or those suffering from severe systemic disease, because it does not allow vigorous working and because wear and/or loosening seems to take place faster compared with other joint replacements (hip, knee…). 

 

Rehabilitation and Physiotherapy
Rehabilitation of elbow surgery is crucial to get a good result and is performed according to well codified protocols. Generally, elbow arthroscopy allows a faster recovery, because the pain is less sever compared with open surgery. The goal is to start early rehabilitation to prevent stiffness and muscle atrophy.

 

 


(In the website you can find general guidance: it is always necessary to strictly follow the advice of the surgeon and your physiotherapist providing your treating.)

 

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Last Updated on Tuesday, 11 January 2011 10:59