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J Am Acad Orthop Surg, Vol 16, No 2, February 2008, 77-87.
© 2008 the American Academy of Orthopaedic Surgeons
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Primary Osteoarthritis of the Elbow: Current Treatment Options

Emilie V. Cheung, MD, Robert Adams, OPA-C and Bernard F. Morrey, MD

Dr. Cheung is Assistant Professor, Department of Orthopaedic Surgery and Sports Medicine, Stanford Hospital and Clinics, Stanford, CA. Mr. Adams is Physician’s Assistant, Mayo Clinic, Rochester, MN. Dr. Morrey is Professor, Department of Orthopedic Surgery, Mayo Clinic.

None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Cheung, Mr. Adams, and Dr. Morrey.

Reprint requests: Dr. Cheung, Stanford Hospital and Clinics, 300 Pasteur Drive, Edwards R-155, Stanford, CA 94305-5335.

In the elbow, as in other joints, primary osteoarthritis is characterized by pain, stiffness, mechanical symptoms, and weakness. But primary osteoarthritis of the elbow is unique in that there is relative preservation of articular cartilage and maintenance of joint space, with hypertrophic osteophyte formation and capsular contracture. Medical treatment and physical therapy may be initiated in the early stages of the disease process. Surgical treatment options include arthroscopic osteocapsular débridement, open ulnohumeral arthroplasty, distraction interposition arthroplasty, and total elbow arthroplasty. The potential for instability and loosening following total elbow arthroplasty in the setting of primary osteoarthritis limits the clinical application of this procedure. This patient population is generally younger than that recommended for total elbow arthroplasty, and their higher functional demands have limited the long-term success of this treatment option. The improvement in arthroscopic débridement techniques is perhaps the greatest advancement in the treatment of osteoarthritis of the elbow in recent years.






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