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Radiocapitellar Arthritis M19.029 715.12

Radiocapitellar Arthritis

synonyms: elbow arthritis, elbow osteoarthritis, radiocapitellar osteoarthritis

Radiocapitellar Arthritis ICD-10

Radiocapitellar Arthritis ICD-9

  • 715.12

Radiocapitellar Arthritis Etiology / Epidemiology / Natural History

  • Arthritis isolated to the radiocapitellar joint.
  • Uncommon
  • Most common etiologies: late sequela of either radial head fracture, capitellar fracture, chondral contusion of the capitellum, or osteochondral lesions of the capitellum.

Radiocapitellar Arthritis Anatomy

Radiocapitellar Arthritis Clinical Evaluation

  • Must rule out medial elbow instability and DRUJ instability.

Radiocapitellar Arthritis Xray / Diagnositc Tests

Radiocapitellar Arthritis Classification / Treatment

  • Nonoperative: NSAIDs, activity modifications, avoid activities which load the joint, ROM exercises for flexion, extension, pronation, and supination should be performed to prevent further loss of motion and function.
  • Arthrosocpic synovectomy and debridement
  • Radial head excision, with or without a radial head replacement: 80% good outcomes. Consider arthroscopic radial head excision (Menth-Chiari WA, Arthroscopy 2001;17(9):918). Avoid radial head excision in active throwing athletes.

Radiocapitellar Arthritis Associated Injuries / Differential Diagnosis

  • Lateral Epicondylitis
  • Cerival disease with radiculopathy
  • Intraarticular elbow loose body
  • Elbow arthritis
  • Posterolateral rotatory instability
  • Olecranon bursitis
  • Posterior olecranon impingement
  • PIN entrapement
  • Snapping triceps

Radial Head Excision Complications

  • Decreased grip strength
  • Decreased supination and pronation strength
  • Wrist pain
  • Progressive valgus instability
  • Proximal migration of the radius
  • Infection
  • CRPS
  • DVT/PR
  • Risks of anesthesia including heart attack, stroke and death

Radiocapitellar Arthritis Follow-up Care

  • Post-op: Splint with forearm in supination or neutral. Start early active range of motion as soon as possible. Consider Indomethacin 75mg QD/NSAIDs for patients with complex dislocations for HO reduction.
  • 7-10 Days: Evaluate incision, remove stitches, Begin early active range of motion as soon as possible. Start physical therapy. Avoid flexion in pronation.
  • 6 Weeks: Consider static progressive nightime extension splinting if a flexion contracture is present 6 weeks after injury. 10° to 15° flexion contractures are not uncommon.
  • 3 Months: Progress with ROM. May take 6-12 months to regain ROM. Begin sport specific therapy.
  • 6 Months: May return to full activities provided patient is asymptomatic
  • 1Yr: Assess outcomes, repeat xrays.
  • Radial Head Fracture Rehab Protocol.
  • See also Elbow Outcome Measures.

Radiocapitellar Arthritis Review References