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Elbow Osteoarthritis

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Osteoarthritis of the elbow — primary and post-traumatic, conservative and surgical options.

Updated Aug 2026
A hand-drawn illustration of a faceless older person unable to fully straighten a stiff painful elbow.
Lateral X-ray showing osteoarthritis of the elbow — joint space narrowing and bone spur formation. Kieran Hirpara 4.0

What you're feeling

You may notice a deep ache in your elbow that feels like it is coming from inside the joint itself. This pain often starts slowly and gets worse over time. It is most common in men over the age of 40 who have done heavy manual work or had an elbow injury in the past. You might feel stiffness when you first wake up in the morning. This stiffness usually loosens up as you move your arm around.

The pain tends to flare up when you use your elbow to its full limit. You might feel a sharp catch or grind when you try to straighten your arm completely or bend it all the way in. Everyday tasks can become difficult because of this restricted movement. Simple actions like reaching for a high shelf, lifting a heavy grocery bag, or turning a doorknob may hurt or feel stuck. You might also notice tingling or numbness in your ring and little fingers. This happens because swollen tissue in the elbow can press on the ulnar nerve.

Resting your arm often helps reduce the ache, but the pain can return when you resume your usual activities. You may find that you avoid using your elbow to prevent discomfort. This can make daily routines feel more challenging than they used to be. Understanding these symptoms helps explain why your surgeon recommends specific treatments. Non-surgical options are usually the first step to manage early symptoms. If the pain persists or limits your movement significantly, surgical options like arthroscopic debridement or joint replacement may be discussed. These procedures aim to remove bone spurs and smooth the joint surface to relieve pain and restore function. Your treatment plan will depend on the severity of your arthritis and your daily needs.

What's actually happening

Osteoarthritis is wear-and-tear arthritis. It changes how your elbow moves. The joint is where two bones meet. In your elbow, this usually starts in the ulnohumeral compartment. This is the main hinge area. You may also notice narrowing in the radiocapitellar articulation. This is the smaller joint on the side of your elbow.

As the cartilage wears down, your body tries to heal itself. It grows extra bone called osteophytes. These are bony spurs. They can block movement. For example, a spur on the capitellum might hit the radial head when you straighten your arm. This causes a mechanical block. You might feel pain or stiffness when you try to extend your elbow fully.

The ligaments that hold your elbow together can also weaken. The ulnar collateral ligament is a key rope-like structure. If it becomes deficient, pressure increases in other parts of the joint. This uneven stress can change the angle of your arm. It may cause a slight outward bend known as increased carrying angle. This shifts how force travels through your bones.

Sometimes, extra bone forms after an injury or surgery. This is heterotopic ossification. It can create a hard block to function. It is not just about the bones changing shape. Soft tissue tightness also plays a role. For instance, flexion contracture in some cases is not primarily due to bony changes.

Your surgeon sees these changes on imaging. The goal of treatment is to restore smooth movement. We may recommend nonoperative steps first. These include rest and therapy. If these do not help, we might suggest arthroscopic osteocapsular arthroplasty. This is a keyhole surgery to remove bone spurs and tighten the joint capsule. It is safe for mild to moderate cases. It improves range of motion with low complication rates.

In severe cases, joint replacement may be considered. However, total elbow replacement is often not ideal for active patients. It has higher complication rates and limited durability. We carefully weigh these risks against your daily needs. Our aim is to give you a stable, functional elbow that fits your lifestyle.

What we can do about it

At Mater Private Hospital Rockhampton, Dr Kieran Hirpara approaches elbow osteoarthritis by matching treatment to your daily needs and the stage of wear-and-tear in your joint. We start with non-surgical care because it often provides meaningful relief in the early stages. Your journey begins with activity changes to avoid positions that trigger pain, such as fully straightening or bending the elbow against resistance. We recommend physiotherapy or hand therapy to maintain movement and strengthen the muscles around the joint. You should give this conservative approach a fair trial for several weeks to see if it reduces your symptoms before considering further steps.

If movement and rest are not enough, we discuss medical management to control pain and inflammation. This may include standard pain relief medications or anti-inflammatories to help you manage daily tasks. We also consider injections into the joint. Cortisone injections can reduce swelling and pain for a limited period, often lasting weeks to months. Hyaluronic acid injections aim to lubricate the joint, while platelet-rich plasma (PRP) uses your own blood components to potentially support healing. The duration of relief varies for each person and each type of injection, so we review your response carefully to decide if repeating them is worthwhile.

Surgery is considered only when non-operative care has not given you enough improvement or if your symptoms are disabling. We look at the severity of degeneration, your age, and how much you rely on your arm for work or hobbies. Procedures such as arthroscopic debridement remove loose bone or tissue to improve motion and reduce pain, while total elbow replacement may be an option for severe arthritis in specific cases. We present these options as a shared decision, ensuring you understand the potential benefits and risks based on current evidence before moving forward.

What to expect

Your journey with elbow wear-and-tear arthritis usually begins with non-surgical care. This is the standard first step for early management. Your surgeon will tailor this approach to your specific symptoms, age, and daily needs. For many people, these conservative measures provide meaningful relief in the early stages. You may find that rest, activity modification, and simple pain management help you manage discomfort without needing an operation.

If symptoms persist or worsen, surgical options become part of the conversation. The choice depends on how severe your joint degeneration is and how active you want to remain. For mild to moderate arthritis, arthroscopic debridement is often recommended. This minimally invasive procedure removes loose tissue and bone spurs to improve motion and reduce pain. Most patients experience satisfactory function and pain relief with a low chance of needing reoperation in the medium term. Open surgery offers similar results for those who need more extensive cleaning of the joint.

Total elbow replacement is generally not recommended for active patients. This is because it carries higher complication rates and limited durability for those who use their arms frequently. However, it remains a reasonable option for select patients with severe arthritis who have lower physical demands. If you are younger or highly active with end-stage arthritis, other procedures like hemiarthroplasty or interposition arthroplasty may be considered. These carry higher revision rates but allow for greater activity levels than total replacement.

Overall, the outlook is positive when treatment is matched to your condition. Most patients undergoing debridement or joint-preserving surgeries have an uneventful recovery with a painless elbow and satisfactory function at short-term follow-up. While some motion loss can occur over time, the goal is to restore stability and limit further progression. Your surgeon will guide you through these choices, ensuring you understand the realistic benefits and limitations of each path.

When to see someone

See your GP if you have persistent elbow pain that does not improve with rest. Ask for a specialist review if you experience weakness, instability, or locking. Symptoms that interfere with sleep or work also warrant assessment. Sudden worsening of pain is another reason to seek help. Primary elbow osteoarthritis often presents with pain and limited movement. It may also cause ulnar nerve symptoms. Nonsurgical management is the first step in early stages. Treatment depends on your age, severity, and daily demands. Early care helps manage wear-and-tear arthritis effectively.

Reviewed by AI synthesis (v2) — pending human review · 18 May 2026.

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For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

Overview

  • Nonoperative treatment is the first step in the early management of elbow osteoarthritis [2].
  • Elbow arthroscopic osteocapsular arthroplasty is a safe and efficacious treatment for patients with mild to moderate osteoarthritis [1].
  • Arthroscopic osteocapsular arthroplasty can be recommended for its favorable overall treatment outcomes for elbow osteoarthritis [29].
  • Arthroscopic debridement for primary degenerative osteoarthritis of the elbow results in statistically significant and clinically relevant improvement in elbow range of motion and clinical outcomes with low complication and reoperation rates [16].
  • Computer simulation studies recommend arthroscopic debridement in the surgical management of patients with osteoarthritis of the elbow [5].
  • Open and arthroscopic debridement procedures are safe and effective in the treatment of elbow osteoarthritis [27].
  • Capsulectomy and debridement for primary osteoarthritis of the elbow through a medial trans-flexor approach is associated with a low rate of complications and is safe and effective [3].
  • Shoulder arthroplasty is a reasonable option for select patients with osteoarthritis [7].
  • Elbow arthroplasty remains a poor option for active patients due to high rates of complications and limited durability [7].
  • Total elbow replacement is a viable option for severe arthropathy in patients with congenital afibrinogenemia, achieving satisfactory results with no complications [11].
  • The indications for total elbow arthroplasty are broadening, with use for acute trauma and osteoarthritis becoming increasingly common [14].
  • Elbow hemiarthroplasty is an option for young or active patients with end-stage posttraumatic arthritis who are unwilling to accept activity limitations, though high rates of revision surgery and revision to total elbow arthroplasty occur [22].
  • Interposition elbow arthroplasty using fascia lata graft for post-traumatic elbow osteoarthritis without ligament reconstruction provides favorable surgical outcomes with high satisfaction rates among young patients [26].

Anatomy & Pathophysiology

  • Osteophytic change occurs predominantly in the ulnohumeral compartment of the elbow [33].
  • Joint space narrowing more frequently affects the radiocapitellar articulation [33].
  • Normal kinematics was preserved in the osteoarthritic elbow with a normal radiocapitellar joint [13].
  • Three-dimensional computational models identified unique regions of impingement, such as between the radial head and a posterior capitellar osteophyte in extension [34].
  • An increase in carrying angle is associated with radial deviation of stress [23].
  • Deficiency of the ulnar collateral ligament (UCL) increased contact pressure within the posteromedial compartment of the elbow with an associated decrease in the contact area [46].
  • Elbow ligament reconstruction effectively restores stability and limits progression to osteoarthritis in the long term [32].
  • Both posterolateral and posteromedial rotatory instability must be addressed surgically to restore elbow stability [40].
  • Heterotopic ossification should be considered in patients with a mechanical block to function after injury to the elbow or surgery [39].
  • Flexion contracture is not primarily related to bony changes of the elbow [44].

Classification

  • The prevalence of elbow osteoarthritis is 55.0% in respondents aged 40 years or older [8].
  • The symptomatic prevalence of elbow osteoarthritis is 22.6% in respondents aged 40 years or older [8].
  • Older age is a significant risk factor for elbow osteoarthritis [8].
  • Male sex is a significant risk factor for elbow osteoarthritis [8].
  • A history of elbow trauma is a significant risk factor for elbow osteoarthritis [8].
  • Primary osteoarthritis of the elbow is characterized by relative preservation of articular cartilage [10].
  • Primary osteoarthritis of the elbow is characterized by maintenance of joint space [10].
  • Primary osteoarthritis of the elbow is characterized by hypertrophic osteophyte formation [10].
  • Normal kinematics is preserved in the osteoarthritic elbow with a normal radiocapitellar joint (OAN group) [13].
  • Both the BM and HR classification systems demonstrated substantial intraobserver and interobserver reliability for evaluating radiographic severity of post-traumatic arthritis and primary osteoarthritis of the elbow [25].
  • The bony landmarks classification system effectively delineated osteophyte distribution in elbow patients [36].

Clinical Presentation

  • Nonoperative treatment remains the first step in the early management of elbow osteoarthritis [2].
  • Nonsurgical management may provide relief in early stages of elbow arthritis [15].
  • The appropriate treatment for elbow arthritis depends on the etiology, severity, patient age, and functional demands [4].
  • Surgical treatment for elbow arthritis is based on disease etiology, severity of degeneration, and patient age [6].
  • Treatment of elbow arthritis must be individualized based on etiology, severity, patient age, and functional demands [15].
  • The prevalence of elbow osteoarthritis was 55.0% in respondents aged 40 years or older [8].
  • The symptomatic prevalence of elbow osteoarthritis was 22.6% in respondents aged 40 years or older [8].
  • Older age is a significant risk factor for elbow osteoarthritis [8].
  • Male sex is a significant risk factor for elbow osteoarthritis [8].
  • A history of elbow trauma is a significant risk factor for elbow osteoarthritis [8].
  • Primary osteoarthritis of the elbow is characterized by relative preservation of articular cartilage and maintenance of joint space with hypertrophic osteophyte formation [10].
  • Primary elbow osteoarthritis predominantly affects middle-aged men undertaking heavy manual work [28].
  • Primary elbow osteoarthritis presents with pain, limited movement, and potential ulnar nerve symptoms [28].
  • Arthroscopic treatment of elbow osteoarthritis addresses pathologic processes associated with arthritis of the elbow [20].
  • Arthroscopic treatment of elbow osteoarthritis is indicated for pain at motion extremes [15].
  • Total elbow arthroplasty is indicated for pain throughout the arc of motion in elbow arthritis [15].

Investigations

  • Nonoperative treatment remains the first step in the early management of elbow osteoarthritis [2].
  • Primary osteoarthritis of the elbow is unique due to relative preservation of articular cartilage and maintenance of joint space with hypertrophic osteophyte formation [10].
  • Osteophytic change occurs predominantly in the ulnohumeral compartment of the elbow, whereas joint space narrowing more frequently affects the radiocapitellar articulation [33].
  • An increase in carrying angle is associated with radial deviation of stress [23].
  • Both the BM and HR classification systems demonstrated substantial intraobserver and interobserver reliability for evaluating radiographic severity of post-traumatic arthritis and primary osteoarthritis of the elbow [25].
  • CT has greater sensitivity than radiographs for the detection of osteophytes and loose bodies in primary elbow osteoarthritis [51].
  • Three-dimensional computational models identified the locations and volumes of bony impingement in patients with osteoarthritis of the elbow and highlighted unique regions of impingement, such as between the radial head and a posterior capitellar osteophyte in extension [34].
  • Normal kinematics was preserved in the osteoarthritic elbow with a normal radiocapitellar joint (OAN group) [13].
  • The authors recommend performing an MRI if healing does not occur by a reasonable time despite successful bony healing to assess potential cartilage damage [50].

Treatment

Non-Operative Management

  • Nonoperative treatment remains the first step in the early management of elbow osteoarthritis [2].
  • Nonsurgical management may provide relief in early stages of elbow arthritis [15].

Surgical Decision-Making and Indications

  • The appropriate treatment for elbow arthritis depends on the etiology, severity, patient age, and functional demands [4].
  • Surgical treatment for elbow arthritis is based on disease etiology, severity of degeneration, and patient age [6].
  • Treatment of elbow arthritis must be individualized based on etiology, severity, patient age, and functional demands [15].
  • Primary elbow osteoarthritis predominantly affects middle-aged men undertaking heavy manual work, presenting with pain, limited movement, and potential ulnar nerve symptoms [28].

Arthroscopic and Open Debridement

  • Elbow arthroscopic osteocapsular arthroplasty (AOA) is a safe, efficacious treatment for patients with mild to moderate osteoarthritis [1].
  • Capsulectomy and debridement for primary osteoarthritis of the elbow through a medial trans-flexor approach is associated with a low rate of complications and is safe and effective [3].
  • Arthroscopic debridement is recommended in the surgical management of patients with osteoarthritis of the elbow based on computer simulation [5].
  • Elbow arthroscopic debridement for primary degenerative osteoarthritis results in statistically significant and clinically relevant improvement in elbow range of motion and clinical outcomes with low complication and reoperation rates [16].
  • Open and arthroscopic debridement procedures are safe and effective in the treatment of elbow OA [27].
  • Arthroscopic osteocapsular arthroplasty can be recommended for its favorable overall treatment outcomes for elbow osteoarthritis [29].
  • Osteocapsular debridement is an effective surgical treatment option for patients with symptomatic primary elbow osteoarthritis who have failed conservative management [30].
  • Osteocapsular debridement is an effective surgical treatment option for patients with symptomatic primary elbow osteoarthritis who have failed conservative management [31].
  • Surgical debridement is an effective treatment for the disabling symptoms of primary elbow OA with an acceptable complication rate [37].
  • Arthroscopic debridement for elbow osteoarthritis provides satisfactory pain relief, improvement of elbow motion, and good functional outcome [38].
  • Osteocapsular debridement, a non-arthroplasty option, proves to be safe and effective in treating patients with elbow arthritis [47].

Total Elbow Arthroplasty

  • Shoulder arthroplasty is a reasonable option for select patients with osteoarthritis, whereas elbow arthroplasty remains a poor option for active patients due to high rates of complications and limited durability [7].
  • Total elbow replacement is a viable option for severe arthropathy in patients with congenital afibrinogenemia, achieving satisfactory results with no complications [11].
  • The range of indications for total elbow arthroplasty is broadening, with use for acute trauma and osteoarthritis becoming increasingly more common [14].
  • Total elbow arthroplasty is a surgical option for pain throughout the arc of motion in elbow arthritis [15].

Interposition Arthroplasty

  • Interposition elbow arthroplasty using fascia lata graft for post-traumatic elbow osteoarthritis without ligament reconstruction provides favorable surgical outcomes with high satisfaction rates among young patients [26].

Complications

  • Elbow arthroplasty remains a poor option for active patients due to high rates of complications and limited durability [7].
  • Total elbow arthroplasty has an acceptable complication rate [42].
  • Total elbow replacement is a viable option for severe arthropathy in patients with congenital afibrinogenemia, with no complications reported in the case [11].

Recovery

  • Nonoperative treatment is the first step in the early management of elbow osteoarthritis [2].
  • Treatment of elbow arthritis must be individualized based on etiology, severity, patient age, and functional demands [15].
  • Nonsurgical management may provide relief in early stages of elbow arthritis [15].
  • Surgical options for elbow arthritis range from arthroscopic debridement for pain at motion extremes to total elbow arthroplasty for pain throughout the arc of motion [15].
  • Elbow arthroplasty remains a poor option for active patients due to high rates of complications and limited durability [7].
  • Elbow arthroscopic osteocapsular arthroplasty (AOA) is a safe and efficacious treatment for patients with mild to moderate osteoarthritis [1].
  • Arthroscopic debridement provides satisfactory elbow function and improvement in pain with little chance of reoperation at midterm follow-up for both posttraumatic and primary degenerative osteoarthritis [9].
  • Clinical outcomes for primary elbow osteoarthritis patients undergoing arthroscopic OCA improve from preoperative assessment to short- and medium-term follow-up [18].
  • Range of motion (ROM) decreases between short- and medium-term follow-up after arthroscopic OCA for primary elbow osteoarthritis [18].
  • Open and arthroscopic treatment yields similar results in experienced hands, though patients may experience some degree of recurrence or motion loss [56].
  • Capsulectomy and debridement through a medial trans-flexor approach is associated with a low rate of complications and is safe and effective for primary osteoarthritis of the elbow [3].
  • Most patients undergoing open debridement and radiocapitellar replacement have an uneventful postoperative course, painless elbow joint, and satisfactory functional recovery at short-term follow-up [19].
  • Radiocapitellar prosthetic arthroplasty largely preserves elbow kinematics and stability [24].
  • Revision radiocapitellar arthroplasty by mismatched implant components is a salvage option that improved Mayo elbow performance scores from poor to good/excellent with no signs of implant failure at a minimum three-year follow-up [12].
  • Elbow hemiarthroplasty is an option for young or active patients with end-stage posttraumatic arthritis who are unwilling to accept activity limitations, though high rates of revision surgery and revision to total elbow arthroplasty occur [22].
  • Elbow ligament reconstruction effectively restores stability and limits progression to osteoarthritis in the long term [32].

Key Evidence

  • [L4] Elbow AOA is a safe, efficacious treatment for patients with mild to moderate osteoarthritis. [1] (10.1016/j.jhsa.2015.11.018)
  • [L5] Nonoperative treatment remains the first step in the early management of elbow osteoarthritis. [2] (10.2106/jbjs.e.00568)
  • [L4] This approach is associated with a low rate of complications and is safe and effective for the treatment of primary osteoarthritis of the elbow. [3] (10.1016/j.jhsa.2011.07.018)
  • [L5] The appropriate treatment for elbow arthritis depends on the etiology, severity, patient age, and functional demands. [4] (10.1016/j.jhsa.2009.02.019)
  • [L4] The study recommends this technique in the surgical management of patients with osteoarthritis of the elbow. [5] (10.1302/0301-620x.96b2.30714)
  • [L5] Surgical treatment for elbow arthritis is based on disease etiology, severity of degeneration, and patient age. [6] (10.1016/j.jhsa.2007.12.022)
  • [L5] Shoulder arthroplasty is a reasonable option for select patients with osteoarthritis, whereas elbow arthroplasty remains a poor option for active patients due to high rates of complications and limited durability. [7] (10.1016/j.jht.2022.02.002)
  • [L3] The prevalence of elbow OA was 55.0% in respondents aged 40 years or older, with a symptomatic prevalence of 22.6%; older age, male sex, and a history of elbow trauma were identified as significant risk factors. [8] (10.1016/j.jse.2018.02.049)
  • [L3] Patients with either pathology can expect satisfactory elbow function and an improvement in pain with little chance of reoperation at the midterm of the follow-up duration. [9] (10.1016/j.jseint.2021.07.018)
  • [L4] Primary osteoarthritis of the elbow is unique due to relative preservation of articular cartilage and maintenance of joint space with hypertrophic osteophyte formation. [10] (10.5435/00124635-200802000-00005)
  • [L4] The patient achieved satisfactory results with no complications, demonstrating that total elbow replacement is a viable option for severe arthropathy in this rare condition. [11] (10.2106/jbjs.i.00149)
  • [L4] At a minimum of three-year follow-up, both cases improved from poor to good and excellent Mayo elbow performance scores with no signs of implant failure on standard radiographs. [12] (10.1177/17585732241297152)
  • [L4] Normal kinematics was preserved in the osteoarthritic elbow with a normal radiocapitellar joint (OAN group). [13] (10.1016/j.jhsa.2013.02.006)
  • [L2] The range of indications for total elbow arthroplasty is broadening; total elbow arthroplasty for acute trauma and osteoarthritis is becoming increasingly more common. [14] (10.1302/2058-5241.5.190036)
  • [L5] Treatment of elbow arthritis must be individualized based on etiology, severity, patient age, and functional demands; nonsurgical management may provide relief in early stages, while surgical options range from arthroscopic debridement for pain at motion extremes to total elbow arthroplasty for pain throughout the arc of motion. [15] (10.1016/j.jhsa.2012.12.037)
  • [L1] Elbow arthroscopic debridement for primary degenerative osteoarthritis results in statistically significant and clinically relevant improvement in elbow range of motion and clinical outcomes with low complication and reoperation rates. [16] (10.1016/j.arthro.2017.08.247)
  • [L4] Serial assessment of patients with primary elbow OA who underwent arthroscopic OCA showed that the clinical outcomes improved from preoperative assessment to short- and medium-term follow-up, although ROM decreased between short- and medium-term follow-up. [18] (10.1177/23259671231162398)
  • [L4] Most patients had an uneventful postoperative course and have shown a painless elbow joint, with satisfactory functional recovery at short-term follow-up. [19] (10.1016/j.jse.2011.08.071)
  • [L4] This procedure addresses the pathologic processes associated with arthritis of the elbow and was safe and effective in this series. [20] (10.1016/j.jse.2007.04.005)
  • [L4] Elbow hemiarthroplasty is an option for young or active patients with end-stage posttraumatic arthritis who are unwilling to accept activity limitations, though high rates of revision surgery and revision to total elbow arthroplasty occur. [22] (10.5435/jaaos-d-18-00055)
  • [L3] An increase in carrying angle is associated with radial deviation of stress. [23] (10.1097/corr.0000000000002921)
  • [L4] The procedure largely preserves elbow kinematics and stability. [24] (10.1016/j.jse.2014.01.042)
  • [L3] Both the BM and HR classification systems demonstrated substantial intraobserver and interobserver reliability for evaluating radiographic severity of post-traumatic arthritis and primary osteoarthritis of the elbow. [25] (10.1016/j.jse.2014.10.015)
  • [L4] It provides favorable surgical outcomes with high satisfaction rates among young patients with elbow osteoarthritis. [26] (10.1016/j.jhsg.2024.05.002)
  • [L5] However, from the data we obtained the open and arthroscopic debridement procedures seem to be safe and effective in the treatment of elbow OA. [27] (10.1186/s12891-018-2318-x)
  • [L4] Primary elbow osteoarthritis predominantly affects middle-aged men undertaking heavy manual work, presenting with pain, limited movement, and potential ulnar nerve symptoms. [28] (10.1111/j.1758-5740.2010.00089.x)
  • [L4] Arthroscopic osteocapsular arthroplasty can be recommended for its favorable overall treatment outcomes for elbow osteoarthritis. [29] (10.1016/j.jse.2019.09.036)
  • [L1] Osteocapsular debridement is an effective surgical treatment option for patients with symptomatic primary elbow osteoarthritis who have failed conservative management. [30] (10.1016/j.jse.2020.01.061)
  • [L2] Osteocapsular debridement is an effective surgical treatment option for patients with symptomatic primary elbow osteoarthritis who have failed conservative management. [31] (10.1016/j.jse.2020.01.060)
  • [L4] Elbow ligament reconstruction by the technique of O'Driscoll et al effectively restores stability and limits progression to osteoarthritis in the long term. [32] (10.1016/j.jseint.2022.12.009)
  • [L3] Osteophytic change occurs predominantly in the ulnohumeral compartment of the elbow, whereas joint space narrowing more frequently affects the radiocapitellar articulation. [33] (10.1016/j.jse.2006.08.005)
  • [L4] Three-dimensional computational models identified the locations and volumes of bony impingement in patients with osteoarthritis of the elbow and highlighted unique regions of impingement, such as between the radial head and a posterior capitellar osteophyte in extension. [34] (10.1016/j.jhsa.2013.03.035)
  • [L3] The bony landmarks classification system effectively delineated osteophyte distribution in elbow patients. [36] (10.1186/s13018-025-06145-9)
  • [L1] Surgical debridement is an effective treatment for the disabling symptoms of primary elbow OA with an acceptable complication rate. [37] (10.1302/2058-5241.5.190095)
  • [L4] Arthroscopic debridement for elbow osteoarthritis provides satisfactory pain relief, improvement of elbow motion, and good functional outcome. [38] (10.1016/j.jse.2014.01.009)
  • [L4] Its presence should be considered in patients in whom there is a mechanical block to function after injury to the elbow or surgery. [39] (10.1016/j.jse.2007.06.018)
  • [L4] Both directions of instability must be addressed surgically to restore elbow stability. [40] (10.1016/j.injury.2007.01.039)
  • [L5] Total elbow arthroplasty has become a successful reconstruction for painful destructive arthritis about the elbow with an acceptable complication rate. [42] (10.1016/j.jhsa.2009.02.021)
  • [L4] This indicates that flexion contracture is not primarily related to bony changes of the elbow. [44] (10.5435/jaaos-d-17-00110)
  • [L5] Under the conditions tested, deficiency of the UCL increased contact pressure within the posteromedial compartment of the elbow with associated decrease in the contact area. [46] (10.1016/j.arthro.2013.03.046)
  • [Commentary] Osteocapsular debridement, a non-arthroplasty option, proves to be safe and effective in treating patients with elbow arthritis, making the elbow more forgiving than previously thought. [47] (10.1016/j.arthro.2020.10.029)
  • [Case_report] The authors recommend performing an MRI if healing does not occur by a reasonable time despite successful bony healing to assess potential cartilage damage. [50] (10.1007/s00402-005-0018-0)
  • [L1] CT has greater sensitivity than radiographs for the detection of osteophytes and loose bodies in primary elbow osteoarthritis. [51] (10.1016/j.jse.2021.04.001)
  • [Commentary] Open and arthroscopic treatment yields similar results in experienced hands, but patients may have some degree of recurrence or motion loss. [56] (10.1016/j.arthro.2019.02.004)

References

[1] Outcomes of Elbow Arthroscopic Osteocapsular Arthroplasty. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2015.11.018 [2] Management of Elbow Osteoarthritis. The Journal of Bone & Joint Surgery. 2006. DOI: 10.2106/jbjs.e.00568 [3] Capsulectomy and Debridement for Primary Osteoarthritis of the Elbow Through a Medial Trans-Flexor Approach. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2011.07.018 [4] Elbow Arthritis: Current Concepts. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2009.02.019 [5] Arthroscopic debridement in the treatment of patients with osteoarthritis of the elbow, based on computer simulation. The Bone & Joint Journal. 2014. DOI: 10.1302/0301-620x.96b2.30714 [6] Surgical Options for the Arthritic Elbow. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2007.12.022 [7] Surgical management of osteoarthritis in the shoulder and elbow. Journal of Hand Therapy. 2022. DOI: 10.1016/j.jht.2022.02.002 [8] The prevalence of elbow osteoarthritis in Japanese middle-aged and elderly populations: the relationship between risk factors and function. Journal of Shoulder and Elbow Surgery. 2018. DOI: 10.1016/j.jse.2018.02.049 [9] Midterm outcomes and survivorship of arthroscopic elbow debridement: a comparison of posttraumatic versus primary degenerative osteoarthritis. JSES International. 2022. DOI: 10.1016/j.jseint.2021.07.018 [10] Primary Osteoarthritis of the Elbow: Current Treatment Options. Journal of the American Academy of Orthopaedic Surgeons. 2008. DOI: 10.5435/00124635-200802000-00005 [11] Severe Elbow Arthropathy in a Patient with Congenital Afibrinogenemia. The Journal of Bone & Joint Surgery. 2010. DOI: 10.2106/jbjs.i.00149 [12] Revision radiocapitellar arthroplasty by mismatched implant components – A salvage option: A report of two cases with a minimum three-year follow-up. Shoulder & Elbow. 2024. DOI: 10.1177/17585732241297152 [13] Kinematic Changes in Elbow Osteoarthritis: In Vivo and 3-Dimensional Analysis Using Computed Tomographic Data. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.02.006 [14] Global trends in indications for total elbow arthroplasty: a systematic review of national registries. EFORT Open Reviews. 2020. DOI: 10.1302/2058-5241.5.190036 [15] Elbow Arthritis: Current Concepts. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2012.12.037 [16] Arthroscopic Debridement for Primary Degenerative Osteoarthritis of the Elbow Leads to Significant Improvement in Range of Motion and Clinical Outcomes: A Systematic Review. Arthroscopy. 2017. DOI: 10.1016/j.arthro.2017.08.247 [18] Serial Changes in Clinical Outcomes After Arthroscopic Osteocapsular Arthroplasty for Primary Elbow Osteoarthritis: A Medium-term Follow-up Study. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/23259671231162398 [19] Open debridement and radiocapitellar replacement in primary and post-traumatic arthritis of the elbow: a multicenter study. Journal of Shoulder and Elbow Surgery. 2012. DOI: 10.1016/j.jse.2011.08.071 [20] Osteoarthritis of the elbow: Results of arthroscopic osteophyte resection and capsulectomy. Journal of Shoulder and Elbow Surgery. 2008. DOI: 10.1016/j.jse.2007.04.005 [22] Outcomes After Hemiarthroplasty of the Elbow for the Management of Posttraumatic Arthritis: Minimum 2-Year Follow-up. Journal of the American Academy of Orthopaedic Surgeons. 2019. DOI: 10.5435/jaaos-d-18-00055 [23] How Does the Subchondral Bone Density Distribution of the Distal Humerus Change Between Early and Advanced Stages of Osteoarthritis?. Clinical Orthopaedics & Related Research. 2023. DOI: 10.1097/corr.0000000000002921 [24] Radiocapitellar prosthetic arthroplasty: a report of 6 cases and review of the literature. Journal of Shoulder and Elbow Surgery. 2014. 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