Elbow arthritis or osteoarthritis is a condition that results in pain and stiffness (loss of movement) in the elbow. It happens when the cartilage lining your elbow joint wears away. When you move your elbow, instead of having two smooth surfaces sliding over each other, you have bare bone rubbing on bare bone. This is painful and results in a loss of movement.
As people get older, their risk of developing arthritis in any joint increases. It is unusual to see arthritis in people under 55 years of age. Often, arthritis runs in families too, and if you develop arthritis in one joint, you are more likely to have arthritis in other joints.
Several other conditions an make you more likely to develop arthritis:
This starts with a conversation with your doctor to describe the problems you are experiencing with your elbow. You will then be examined, paying careful attention to the movement in your elbow and whether you have pain throughout all movements or just at different points. An X-ray will clearly show the presence of arthritis, with signs of narrowing of the joint due to the cartilage wear.
Mr. Davies often performs a CT scan to look at your elbow in more detail. Often, arthritis can wear away the bone and a CT scan allow this to be measured in three dimensions. These scans are helpful for planning surgery.
For some people, just knowing what the problem is provides some reassurance. The pain may be controlled with simple painkillers, such as paracetamol and anti-inflammatories (if you can take them). This may be coupled with simple changes to your lifestyle, such as a change in your work role or your sport and recreational activities. Elbow arthritis may become more painful over time, but this usually happens gradually.
A course of physiotherapy can be helpful to maintain flexibility in your elbow and find ways of moving it which are less painful.
Steroid injections can provide temporary pain relief in arthritis. It is most suitable for people who have early arthritis, and especially those with rheumatoid arthritis or other types of elbow joint inflammation. Injections can last for several weeks to several months and may be repeated 2-3 times per year.
It is worth noting that injections can increase the chances of infection if you have subsequent elbow surgery. Since infections after elbow replacements are often very problematic to treat, Mr. Davies tends not to recommend repeated injections for treatment of elbow arthritis.
A debridement is a type of joint-preservation surgery that aims to help with your pain and movement without replacement your elbow joint. After obtaining scans to plan surgery, Mr. Davies will discuss the options of keyhole surgery, often called an arthroscopic debridement, or open surgery with you (often called a lateral column procedure or OK procedure). The aim of this surgery is to remove the growths of bone and cartilage called osteophytes that may be catching and causing pain, and may also be limiting your elbow movement. These growths of bone usually occur in people with arthritis in any joint.
This surgery can be very effective at reducing the pain and increasing the movement in your elbow. By preserving your own joint, you will not have to live with the restrictions that people who have an elbow replacement have to live with. Rehabilitation is very important with this surgery and early physiotherapy vital to maintain your range of movement. It is possible that your arthritis continues to progress after this operation and there is a chance that you do not get significant benefit from it. If this is the case, you may be offered an elbow replacement in the future.
Often, the most predictable results can be achieved with an elbow replacement. The exact type of elbow replacement will depend on a number of factors, including:
Elbow replacements are big operations that replace the worn cartilage with a metal and plastic hinge. For most people, they provide excellent pain relief. You are recommended not to lift anything heavier than 5kg after surgery to reduce the risk of the elbow replacement becoming loose.