ELBOW OSTEOARTHRITIS: PATHOGENESIS, CLINICAL PRESENTATION, WORK-UP

Abstract

ABSTRACT Degenerative joint disease of the elbow, although much rarer than in lower limbs, affecting about 2% of population, may be the result of primary and secondary etiologies and may significantly affect the quality of life, leading to pain, loss of motion and functional disability. A detailed medical history combined with physical examination and imaging modalities can help to locate the source of symptoms and choose the appropriate treatment. Nonoperative management is the initial therapy for elbow arthritis and is limited to relief of pain by rest, activity modification, analgesics and nonsteroid anti-inflammatory medications. When conservative management fails, surgical treatment should be used according to the patient’s expectations, age, severity and etiology of elbow arthritis. Patients with posttraumatic and primary elbow osteoarthritis in mild and moderate stage of disease may be treated by arthroscopic osteocapsular arthroplasty which consist of soft tissue and bony debridement, osteophytes and loose bodies removal, synovectomy, capsular release and bony contouring of humerus and ulnae. Total elbow arthroplasty is dedicated to low-demand, elderly patients with rheumatoid, inflammatory, posttraumatic or primary elbow osteoarthritis in severe stage. For younger, high-demand patients with severe osteoarthritis of the elbow which affects the majority of the ulnohumeral articular surface a good option for surgical treatment is interposition arthroplasty with/using auto or allografts.