Elbow osteoarthritis

General information

Osteoarthritis of the elbow joint is a degenerative disease affecting cartilage tissue. It is characterized by deformation and deposition of calcium salts. Violation of the processes of catabolism and anabolism occurring in cartilage tissue leads to decreased volume and production of synovial fluid.

As a result of osteoarthritis, friction increases, the joint gap narrows, and osteophytes grow on the inner surface of the joint. Pathological changes occur in the joint, and the protective lining is lost. The next stage is inflammation, accompanied by pain and reduced mobility.

Causes of the disease

Prerequisites for osteoarthritis include:

•  increased stress on the elbow;
•  Age-related changes in bones and tissues;
•  surgeries performed on the elbow joint;
•  a fracture or injury to the elbow;
•  pathologies (congenital, acquired) of the musculoskeletal system;
•  complication of rheumatoid arthritis therapy;
•  infectious diseases.

Even long-standing injuries can trigger the development of osteoarthritis of the elbow. There is no need to hope that “everything will go away.” Without treatment, the pathology can lead to a limited range of motion and, in the worst case, to complete arm immobility.

Classification

The severity and type of clinical symptoms also depend on the extent of the lesion. Osteoarthritis of the elbow is characterized by the following.

• First degree of osteoarthritis. It is accompanied by a mildly pronounced pain occurring when the elbow is loaded. There are no external manifestations. Backward extension of the arm is limited, but this does not cause much discomfort.
• Second-degree osteoarthritis. There are sharp pains, even at rest. A crepitation is heard at the moment of movement in the elbow joint. It is problematic to bend the arm or move it aside.
• Third degree of deforming osteoarthritis. It is accompanied by an intense pain syndrome. Many people fix the elbow joint in a “safe” position to reduce it. Movement of the arm is impossible.

If arthrosis is neglected, the cartilage is completely destroyed, and the muscles atrophy. That is why it is so important to contact an orthopedic traumatologist and start treatment if elbow joint pain appears.

Symptoms

A person with the first degree of arthrosis of the elbow joint practically does not notice symptoms. The looseness of cartilage provokes the development of the disease, the lagging of its scales from the bone. As a result, the cartilage disintegrates and forms detritus. Its particles float in the joint crevices and fall between the articular surfaces, which rub and erase the cartilage tissue along with the synovial membrane of the capsule. It leads to an inflammatory process in the joint sheath, which produces a large volume of intra-articular fluid. As a result, the cartilage is further destroyed. There is an increase in temperature and swelling in the elbow area. 

Damage to the joint capsule causes severe pain. The more the cartilage tissue is destroyed, the more the bone is exposed, with impaired blood circulation. This is why the intolerable, aching pain, even at night.

As the disease progresses, bone overgrowths (osteophytes) form in the joint, which is accompanied by further deformation of the joint. In this case, the mobility of the hand is significantly limited.

The soreness is initially felt only when the joint is loaded but then progresses to constant unbearable pain.

Untimely referral to a specialist, diagnosis, and treatment of detected arthrosis of the elbow joint can lead to disability. The greatest danger of the disease is the irreversibility of the changes occurring in the joints, and in severe cases, it may be necessary to replace the organ by endoprosthesis. It involves implanting an artificial device in place of the damaged organ, which replaces the function of the elbow joint.

One peculiarity of elbow arthrosis is that it is an asymptomatic course that lasts for a relatively long period of time. Inflammatory processes can give rise to an exacerbation of the disease under a series of circumstances.

Therefore, you should be concerned if you experience any of the following symptoms: 

• increase in temperature throughout the body and in the area of the joint;
• redness of the skin in the elbow area;
• soft tissue swelling in the elbow area;
• limitation of upper extremity mobility, resulting in pain and swelling.

If the above symptoms occur, it is necessary to consult a relevant specialist. After a set of diagnostic measures, he will prescribe the necessary therapy. Surgical intervention is not excluded.

Diagnosis

During the appointment, the doctor examines the patient, studies the elbow, and listens to complaints. To identify the degree of osteoarthritis, may be prescribed:

•  Blood test (needed to assess rheumatoid factor, exclude arthritis);
•  X-ray (helps to determine the stage of elbow osteoarthritis);
• Ultrasound (with its help, the doctor can assess the thickness of the cartilage in the lumen of the articular sac);
•  CT or MRI scan – depending on the stage of osteoarthritis;
•  Densitometry (needed to detect osteoporosis).

Treatment

In the first degree, when the joint gap generalizes, and the subchondral bone thickens, the doctor prescribes drugs to normalize blood circulation and a vitamin complex. In addition to drug therapy, the patient should perform therapeutic exercises and undergo a course of massage.

In the second degree, bone overgrowths (osteophytes) appear, and the narrowing of the articular gap is two times or larger than normal; therefore, medications are prescribed that are injected directly into the joint, as well as drugs with analgesic, anti-inflammatory effect and drugs for the restoration of cartilage tissue. In addition to physical therapy and massage procedures, the doctor recommends electrophoresis, magnetic or laser therapy. Acupuncture may also be prescribed.

In the third degree, medications and other effective treatment methods in the first two stages are used to stop the development of the disease. At this stage, the size of the joint gap is so small that it is almost invisible. In addition, there is an extensive overgrowth of osteophytes with joint deformation, and mobility is almost completely absent. If the measures taken over a long period are ineffective, surgical intervention is the only option.

It is challenging to restore destroyed cartilage tissue on the bare bone. Treatment involves a comprehensive approach, considering the stage of osteoarthritis and the patient’s individual characteristics.

Drugs and techniques, competently selected by a doctor, will help relieve symptoms and stop cartilage destruction. For therapy use:

• Medications. Painkillers and non-steroidal anti-inflammatory drugs, warming ointments, chondroprotectors. Intra-articular injections are performed; hyaluronic acid is most often used, which can restore cartilage elasticity and reduce friction pain.
• Physiotherapeutic procedures (electrophoresis, laser, and magnetic resonance therapy) help restore blood supply to the elbow, relieve inflammation, and start the process of tissue regeneration.   

Operations

If pain and deformity in osteoarthritis of the elbow joint limit a person’s freedom of movement, prescriptions may be prescribed:

• arthroscopic debridement;
• endoprosthetics. Treatment involves replacing the elbow joint with an artificial analog;
• arthroplasty is a tissue-preserving surgery to replace damaged cartilage with synthetic cartilage.

All these treatment options are available in more than 980 hospitals worldwide (https://doctor.global/results/diseases/elbow-osteoarthritis). For example, Arthroscopic elbow debridement can be done in 46 clinics across Germany for an approximate price of $3,2K (https://doctor.global/results/europe/germany/all-cities/all-specializations/procedures/arthroscopic-elbow-debridement).