Elbow Arthritis 715.12

synonyms: elbow DJD, elbow degenerative joint disease, radiohumeral arthritis, ulnohumeral arthritis,

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

• See also Elbow 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, lateralelbow 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).
• Total Elbow arthroplasty.
• Elbow Arthrodesis: most useful at 110 flexion,depends on functions desired and opposite arm function

Elbow Arthritis Associated Injuries / Differential Diagnosis

• Radiocapitellar Arthritis
• Lateral epicondylitis
• Charcot elbow (neuropathic)
• Posterior Elbow Impingement
• Ulnar neuropathy
• Medial Epicondylitis

TEA Complications

• 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

• Gramstad GD, JBJS 2006;88:421.
• O’Driscoll SW JAAOS 1;106:1993
• OKU - Shoulder and Elbow 2nd ed, 2002