synonyms: elbow DJD, elbow degenerative joint disease, radiohumeral arthritis, ulnohumeral arthritis,
Elbow Arthritis ICD-10
Elbow Arthritis ICD-9
- 715.12 (osteoarthritis, localized primary, forearm)
Elbow Arthritis Etiology / Epidemiology / Natural History
- Degenerative arthritis almost exclusively in men usually with hx of repetitive heavy use or overuse of elbow. Carpenters, weightlifters, throwing athletes.
- Mean age at presentation: 55 years.
Elbow Arthritis Anatomy
Elbow Arthritis Clinical Evaluation
- Impingement pain at terminal extension
- Flexion contracture common
- Evaluate any prior surgical scars
Elbow Arthritis Xray / Diagnositc Tests
- A/P, lateral elbow films demonstrate osteophyties on coronoid and olecranon and in coronoid and olecranon fossae. Ulnohumeral and radiohumeral joint space narrowing.
- Often associated with loose bodies
Elbow Arthritis Classification / Treatment
- Fenestration Arthroplasty=ulnohumeral arthroplasty (Morrey BF, JBJS 1992;74B;409).
- Elbow Arthroscopy with debridement and osteocapsular resection. (Nguyen D, Arthroscopy 2006;22:842).
- Interposition arthroplasty: consider for young active patients; no weight-lifting restrictions required, preserves bone stock and allows for conversion to a TEA if necessary. Contraindications: elbow instability, active infection, and pain without motion loss. (Larson AN, Morrey BF. Interposition arthroplasty with an Achilles tendon allograft as a salvage procedure for the elbow. J Bone Joint Surg Am. 2008 Dec;90(12):2714-23.)
- Total Elbow Arthropasty.
- Elbow Arthrodesis: most useful at 110 flexion,depends on functions desired and opposite arm function
Elbow Arthritis Associated Injuries / Differential Diagnosis
- loosening, poly wear
- poly wear can be managed by bushing exchange for pts with semiconstrained liked TEA. Poly wear is more common in young active pts who should be cautioned about recommended activity limitions and lifting restrictions. (Lee BP. JBJS 2005;87A;1080-87)
TEA Follow-up Care
- 5-kg permanent lifting restriction.
Elbow Arthritis Review References