Elbow Arthritis
Patient Information

1. What is arthritis of the elbow?
The elbow joint like other joints in the human body can be affected by degenerative changes (“wear and tear”) of the joint surface (cartilage). This may be due to osteo-arthritis or other inflammatory arthritis like rheumatoid or may occur after a previous injury and fracture. Instead of the normal smooth gliding movement you get an irregular grating movement.

Elbow joint

Fig. 1 Elbow arthritis

2. What are the symptoms?
Arthritis of the elbow can cause pain, stiffness (loss of movement) and locking. Sometimes a piece of bone may work itself lose and may get caught inside the elbow joint. This may produce a sense of jamming and inability to move the elbow. This is called “locking”. This may ease and the elbow may start moving after some time. Locking can be very painful. Swelling of the elbow may occur with arthritis. Occasionally pins and needles in the hand occur due to nerve trapping because of the arthritis.

3. How is arthritis of the elbow diagnosed?
Arthritis of the elbow is diagnosed by the specialist Consultant taking a detailed history of your symptoms and examining your elbow. You will need an X-ray of your elbow and sometimes a CT scan of your elbow (Fig. 1).

4. How is arthritis of the elbow treated?

The treatment depends on the cause, the symptoms, your age and the appearance of the elbow on the X-ray. Treatment consists of both surgical and non-surgical methods.

Non-surgical methods:
This involves rest and activity modification and simple painkillers.

Injections
This may either be steroid or synthetic agents like Synvisc or Hylan. These do not stop the arthritis but do often help the pain. They may have a temporary effect but this may last for some time. Occasionally injections are used to help diagnosis. Synvisc and Hylan are given as a short course of several injections.

Surgery:
This may vary depending on the patients age, requirements and type of arthritis. Surgery may be in the form of Keyhole surgery (elbow arthroscopy), open surgery (OK-Outerbridge Kashiwagi procedure), removal of the radial head or Total elbow replacement. Elbow replacements are more commonly performed for rheumatoid arthritis than osteoarthritis. They may also be done after severe elbow injuries.

5. What happens during the surgery?

Anesthesia:
Surgery for the elbow is usually done under a general anesthetic and or a regional anesthetic. In the latter the nerves supplying the shoulder and the arm is numbed by the use of local anaesthetic. More information on regional anesthetic can be found in the anaesthesia section of this website and anaesthesia information sheets.

The surgery:
in keyhole surgery (elbow arthroscopy) you will have small, 4-5mm, cuts around your elbow, which do not normally have any stitches. We use steristrips. In open surgery, you will have an incision to the back or side of your elbow. Your arm will be in a sling after surgery.

5. What are the benefits and risks of surgery?

Benefits: reduced pain and improved function of the elbow Risks of surgery: Infection, stiffness of the elbow, nerve injury leading to weakness or numbness, recurrent or persistent pain and failure of a replacement over time. Occasionally a haematoma occurs (collection of blood under the wound), which can slow down or prevent wound healing.

6. What happens after surgery?
In most instances you can go home on the same day of surgery except when you have an elbow replacement. You will have a sling, which can be removed after a day. Swelling around the elbow is normal after surgery, however it will settle down after a few days. When you have an elbow joint replacement, you will need to stay in hospital for a couple of days.

Physiotherapy:
this is a very important part of the treatment after surgery. You will see a physiotherapist who will teach you exercises to help you regain and maintain your movement and strength after surgery.

Driving:
Keyhole surgery: 2- 3 weeks after the operation. However if you drive an HGV it is advisable to delay driving until your elbow is pain free and strong, normally after 4 weeks.

Returning to work
light duties, like office work; 3-4 weeks after surgery. Heavy work; 6 weeks after surgery. After elbow replacement one should not lift anything more than 2lbs (1 Kg) or repetitively anything more than 1lb.

Follow-up appointments:
2 weeks after surgery you will have to see a nurse to check your wound. This may be at the hospital or may be your practice nurse. You will usually see the consultant 6 weeks after surgery but please ring on the number below if you have any problems and we will arrange to see you earlier if necessary.

Registered company no: 6728219 | Registered in England