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WHAT IS ELBOW ARTHRITIS?

The elbow joint is a hinge joint which is affected by arthritis just like the hip, knee and shoulder joint. The surfaces of the joint are lined by soft cartilage, which is important for the smooth motion of joints. With arthritis, cartilage becomes destroyed causing bone to rub on bone. Extra pieces of bone eventually grow around the edge of the joint leading to pain, swelling and stiffening.

 

WHAT IS THE CAUSE OF ELBOW ARTHRITIS?

Arthritis often occurs with no recognisable cause. Rheumatoid arthritis is a common cause in the elbow. It can also occur after a previous injury such as a fracture or a dislocation.


WHAT ARE THE SYMPTOMS?

Diagnosis is usually by a good history, examination and taking x-rays. X-rays show the loss of normal space between the bones of the joint and the presence of extra bony spurs.


HOW IS THIS DIAGNOSED?

The main symptoms of elbow arthritis are pain, which is made worse by movement. Initially patients experience grating and locking sensation in the elbow. Locking is caused by loose pieces of bone or cartilage becoming stuck between the ends of the bone. This then leads to a gradual loss of motion and stiffness. Joint swelling occurs as inflammation due to the arthritis produces more fluid.


WHAT IS THE TREATMENT?

In the early stages elbow arthritis is treated with painkilling medication and injections of Cortisone into the joint. It is important keep the elbow as mobile as possible. This is done with physiotherapy. Once it reaches a stage where pain becomes unbearable surgical options are considered.

Arthroscopic surgery is a good option if there is a loose piece of bone in the elbow causing locking. After making small holes on the inside and the outside of the elbow a telescope is introduced and pieces of loose cartilage or bone are removed. It is also possible to smoothen bone cartilage to try and improve the symptoms. Unfortunately the results of this are less predictable.

A procedure known as the OK procedure is sometimes used. A cut is made over the back of the elbow joint and the bones are explored. A hole is the made in the bone of the lower arm and extra bits of bone are removed. Through this hole the front of the joint is also cleared of loose pieces of bone. This often gives considerable pain relief and increases the range of motion in the elbow.

The final stage of treatment of elbow arthritis is a total joint replacement. This is a very effective treatment in providing excellent pain relief and a good functional range of motion. The prosthesis is made of two parts. It has one portion, which is introduced into the humerus, and one into the ulna. A locking pin then connects the two implants.