Arthritis of the Elbow

Selected Features of Our Program

Evaluation and Diagnosis

Arthritis is when a joint loses the cartilage layer on the ends of the bones that lets them move smoothly over each other. As the cartilage thins out, the joint becomes more painful and loses motion. The pain is usually the worst when trying to fully straighten and fully bend the elbow. Eventually all the cartilage will be gone with bone grinding against bone. Symptoms include swelling, catching, and even locking. Arthritis comes in three flavors: osteoarthritis, post-traumatic arthritis and inflammatory arthritis. Osteoarthritis is simply wear and tear as the body ages and only affects older patients. Post-traumatic arthritis results from a fracture or dislocation of the joint damaging the cartilage and causing it to wear out faster than normal. There are many special inflammatory arthritis conditions such as rheumatoid arthritis that can cause especially severe damage to joints in fairly young patients. These inflammatory arthritis conditions require special laboratory tests on blood samples to make the diagnosis. The other two types of arthritis can be diagnosed by simple office examination and x-ray.

Treatment and Recovery

Arthritis treatment starts with the basics of a non-surgical program. Therapy includes gentle range of motion exercises, thermal modalities, and strengthening. Oral anti-inflammatory medication and injected cortisone help with pain considerably. Modifying how certain key activities are performed takes much of the stress off the joint. A small proportion of patients will require some form of surgical treatment. The simplest form of surgery consists of cleaning the arthritic debris out of the elbow joint and removing bone spurs to improve motion. This can be done either with a short incision or arthroscopically with a fiber-optic camera and no significant scars. Rehabilitation after this operation emphasizes daily motion exercises to ensure that the patient regains as much function as possible. This is all that most patients with osteoarthritis and post-traumatic arthritis require. Patients with inflammatory arthritis conditions will sometimes need to go on to the more advanced form of surgical treatment where the whole elbow joint is replaced with a prosthesis made of metal and high density plastic. After joint replacement, rehabilitation is actually not as vigorous as with the simpler surgery. However, the patient is instructed on very stringent limitations that the prosthesis can handle in terms of lifting and carrying heavier objects. Both types of surgery are very effective in terms of relieving pain. The patient and surgeon must choose carefully to match the type of surgery with the lifestyle that the patient wishes to live.