The Arthritic Elbow



Elbow arthritis may be the end stage of different aetiologies. Key clinical aspects and diagnostics strategies for primary osteoarthritis of the elbow, rheumatoid arthritis and posttraumatic conditions are reviewed. Arthroscopic and open procedures are discussed. Total elbow arthroplasty has proved to be an optimal solution for patients with severe joint damage. However, an adequate indication and a delicate surgical technique are essential to reduce the rate of complications. This chapter will provide the reader a simple but thoughtful approach to the arthritic elbow.


Arthritis Total elbow arthroplasty Arthroscopy 


  1. 1.
    Ortner DJ. Description and classification of degenerative bone changes in the distal joint surfaces of the humerus. Am J Phys Anthropol. 1968;28:139–55.PubMedCrossRefGoogle Scholar
  2. 2.
    Silman AJ, Hochberg MC. Epidemiology of the rheumatic diseases. Oxford: Oxford University Press; 1993.Google Scholar
  3. 3.
    Stanley D. Prevalence and etiology of symptomatic elbow osteoarthritis. J Shoulder Elbow Surg. 1994;3(6):386–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Kashiwagi D. Intra-articular changes of the osteoarthritis elbow, especially about the fossa olecrani. J Jpn Orthop Assoc 1978;52:1367–82.Google Scholar
  5. 5.
    Kim SJ, Shin SJ. Arthroscopic treatment for limitation of motion of the elbow. Clin Orthop Relat Res. 2000;375:140–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Nguyen D, Proper SIW, MacDermid JC, et al. Functional outcomes of arthroscopic capsular release of the elbow. Arthroscopy. 2006;8:842–9.CrossRefGoogle Scholar
  7. 7.
    Shahane SA, Stanley D. A posterior approach to the elbow joint. J Bone Joint Surg Br. 1999;81(6):1020–2.PubMedCrossRefGoogle Scholar
  8. 8.
    Pooley J. Unicompartmental elbow replacement: development of a lateral replacement elbow (LRE) arthroplasty. Tech Shoulder Elbow Surg. 2007;8:204–12.CrossRefGoogle Scholar
  9. 9.
    Nolla J, Ring D, Lozano-Calderon S, Jupiter JB. Interposition arthroplasty of the elbow with hinged external fixation for post-traumatic arthritis. J Shoulder Elbow Surg. 2008;17(3):459–64.PubMedCrossRefGoogle Scholar
  10. 10.
    Larson AN, Morrey BF. Interposition arthroplasty with an Achilles tendon allograft as a salvage procedure for the elbow. J Bone Joint Surg Am. 2008;90(12):2714–23.PubMedCrossRefGoogle Scholar
  11. 11.
    Larson AN, Adams RA, Morrey BF. Revision interposition arthroplasty of the elbow. J Bone Joint Surg Br. 2010;92(9):1273–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Blaine TA, Adams R, Morrey BF. Total elbow arthroplasty after interposition arthroplasty for elbow arthritis. J Bone Joint Surg Am. 2005;87:286–92.PubMedCrossRefGoogle Scholar
  13. 13.
    Koller H, Kolb K, Assuncao A, Kolb W, Holz U. The fate of elbow arthrodesis: indications, techniques, and outcome in fourteen patients. J Shoulder Elbow Surg. 2008;17(2):293–306.PubMedCrossRefGoogle Scholar
  14. 14.
    Kelly EW, Bryce R, Coghlan J, Simon B. Arthroscopic debridement without radial head excision of the osteoarthritic elbow. Arthroscopy. 2007;23:151.PubMedCrossRefGoogle Scholar
  15. 15.
    Krishnan SG, Harkins DC, Pennington SD, Harrison DK, Burkhead WZ. Arthroscopic ulnohumeral arthroplasty for degenerative arthritis of the elbow in patients under 50 years of age. J Shoulder Elbow Surg. 2007;16:443.PubMedCrossRefGoogle Scholar
  16. 16.
    Antuña SA, Morrey BF, Adams RA, O’Driscoll SW. Ulnohumeral arthroplasty for primary degenerative arthritis of the elbow: long-term outcome and complications. J Bone Joint Surg. 2002;84-A:2168–73.PubMedGoogle Scholar
  17. 17.
    Morrey BF. Primary degenerative arthritis of the elbow. Treatment by ulnohumeral arthroplasty. J Bone Joint Surg. 1992;74-B:409–13.Google Scholar
  18. 18.
    Sarris I, Riano FA, Goebel F, Goitz RJ, Sotereanos DG. Ulnohumeral arthroplasty: results in primary degenerative arthritis of the elbow. Clin Orthop Relat Res. 2004;420:190–3.PubMedCrossRefGoogle Scholar
  19. 19.
    Stanley D, Winson IG. A surgical approach to the elbow. J Bone Joint Surg Br. 1990;72:728–9.PubMedGoogle Scholar
  20. 20.
    Kashiwagi D. Osteoarthritis of the elbow joint. Intraarticular changes and the special operative procedure, Outerbridge-Kashiwagi method O-K method. In: Kashiwagi D, editor. The elbow joint. Proceedings of the international congress, Japan. Amsterdam: Elsevier; 1985. p. 177–88.Google Scholar
  21. 21.
    Tsuge K, Mizuseki T. Debridement arthroplasty for advanced primary osteoarthritis of the elbow. Results of a new technique used for 29 elbows. J Bone Joint Surg Br. 1994;76:641–6.PubMedGoogle Scholar
  22. 22.
    Adams JE, Wolff 3rd LH, Merten SM, et al. Osteoarthritis of the elbow: results of arthroscopic osteophytes resection and capsulectomy. J Shoulder Elbow Surg. 2008;17:126–31.PubMedCrossRefGoogle Scholar
  23. 23.
    Ogilvie-Harris DJ, Gordon R, MacKay M. Arthroscopic treatment for posterior impingement in degenerative arthritis of the elbow. Arthroscopy. 1995;11:437–43.PubMedCrossRefGoogle Scholar
  24. 24.
    Redden JF, Stanley D. Arthroscopic fenestration of the olecranon fossa in the treatment of osteoarthritis of the elbow. Arthroscopy. 1993;9:14–6.PubMedCrossRefGoogle Scholar
  25. 25.
    O’Driscoll SW. Arthroscopic treatment for osteoarthritis of the elbow. Orthop Clin North Am. 1995;26:691–706.PubMedGoogle Scholar
  26. 26.
    Minami M, Kato S, Kashiwagi D. Outerbridge–Kashiwagi method for arthroplasty of osteoarthritis of the elbow. 44 elbows followed for 8–16 years. J Orthop Sci. 1996;1:11.Google Scholar
  27. 27.
    Cohen AP, Redden JF, Stanley D. Treatment of osteoarthritis of the elbow: a comparison of open and arthroscopic debridement. Arthroscopy. 2000;16:701–6.PubMedCrossRefGoogle Scholar
  28. 28.
    Forster MC, Clark DI, Lunn PG. Elbow osteoarthritis: prognostic indicators in ulnohumeral debridement – the Outerbridge–Kashiwagi procedure. J Shoulder Elbow Surg. 2001;10:557–60.PubMedCrossRefGoogle Scholar
  29. 29.
    McLaughlin II RE, Savoie III FH, Field LD, Ramsey JR. Arthroscopic treatment of the arthritic elbow due to primary radiocapitellar arthritis. Arthroscopy. 2006;22:63–9.PubMedCrossRefGoogle Scholar
  30. 30.
    Kelly EW, Morrey BF, O’Driscoll SW. Complications of elbow arthroscopy. J Bone Joint Surg Am. 2001;83-A(1):25–34.PubMedGoogle Scholar
  31. 31.
    Gofton WT, King GJ. Heterotopic ossification following elbow arthroscopy. Arthroscopy. 2001;17(E2):1–5.CrossRefGoogle Scholar
  32. 32.
    Adla DN, Stanley D. Primary elbow osteoarthritis: an updated review. Shoulder Elbow. 2011;3:41–8.CrossRefGoogle Scholar
  33. 33.
    Menth-Chiari WA, Ruch DS, Poehling GG. Arthroscopic excision of the radial head: clinical outcome in 12 patients with post-traumatic arthritis after fracture of the radial head or rheumatoid arthritis. Arthroscopy. 2001;17(9):918–23.PubMedCrossRefGoogle Scholar
  34. 34.
    Rymaszewski LA, Mackay I, Amis AA, Miller JH. Long-term effects of excision of the radial head in rheumatoid arthritis. J Bone Joint Surg Br. 1984;66(1):109–13.PubMedGoogle Scholar
  35. 35.
    Lee BP, Morrey BF. Arthroscopic synovectomy of the elbow for rheumatoid arthritis. A prospective study. J Bone Joint Surg Br. 1997;79(5):770–2.PubMedCrossRefGoogle Scholar
  36. 36.
    Gschwend N, Scheier NH, Baehler AR. Long-term results of the GSB III elbow arthroplasty. J Bone Joint Surg Br. 1999;81(6):1005–12.PubMedCrossRefGoogle Scholar
  37. 37.
    Gill DR, Morrey BF. The Coonrad-Morrey total elbow arthroplasty in patients who have rheumatoid arthritis. A ten to fifteen-year follow-up study. J Bone Joint Surg Am. 1998;80(9):1327–35.PubMedGoogle Scholar
  38. 38.
    Qureshi F, Draviaraj KP, Stanley D. The Kudo 5 total elbow replacement in the treatment of the rheumatoid elbow: results at a minimum of ten years. J Bone Joint Surg Br. 2010;92(10):1416–21.PubMedCrossRefGoogle Scholar
  39. 39.
    Little CP, Graham AJ, Karatzas G, Woods DA, Carr AJ. Outcomes of total elbow arthroplasty for rheumatoid arthritis: comparative study of three implants. J Bone Joint Surg Am. 2005;87(11):2439–48.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryHarrogate & District NHS Foundation TrustHarrogateUK
  2. 2.Orthopaedic DepartmentSheffield Teaching Hospitals NHS Foundation TrustSheffieldUK

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