Arthrosis of the elbow

Wear of the cartilage surfaces of the elbow joint may occur without any obvious reason (idiopathic arthrosis), due to heavy work (e.g. heavy lifting above the head or heavy strain during training such as body building, spear throwing etc.), after accidents with bone fractures or after infections.
In case of sufficent joint congruency, arthroscopic therapy is indicated in order to eliminate pain and movement restrictions (see above). Only if joint deformities are given, an open intervention may be required.

Technique

In case of open arthrolysis, the joint is mobilized and osteophytes are removed. Thus, improvement of movability and reduction of pain are usually achieved. Only in severe cases, elbow prosthesis may be required. Like in all joint surgery, the underlying disease determines post-surgical success. On principle, this indication should be given for older patients only, except if patients suffering from rheumatism are affected.
Patients suffering from rheumatoid arthritis will profit from an prosthesis implantation already in younger age, but with them, the risk of a loosening of the implants is not as high as with very active patients.

Fig.68 a, b: X-ray of a severe osteoarthritis of the elbow before (a) and after implantation of an elbow prosthesis (b)

Follow-up treatment

Temporary immobilization using an orthesis is important; then functional follow-up treatment is started. This treatment will take about 6 months until a satisfactory result can be achieved.