degenerative arthritis-of-the-elbow
TRANSCRIPT
DEGENERATIVE ARTHRITIS of the ELBOW
ETIOLOGY
• Primary• Secondary
– Trauma• Fracture• Dislocation
– OCD– Sepsis
CLINICAL 1 • Presentation
– Male– 50-60– Discomfort– Stiffness– +/- locking & effusions
CLINICAL 2 • Pain
– activity related (carrying/throwing) – often localised to olecranon fossa
• Stiffness– Flexion loss (hand to mouth)– Extension loss (little functional problem)
• Locking– characteristic LB
INVESTIGATIONS
• Plain XR– AP (ossification fossae)– Lateral (osteophytes - coronoid & olecranon)
• CT scan – loose body
• Arthroscopy
NON-OPERATIVE TREATMENT
• often causes only minor symptoms (esp early)
• Advice• Analgesia• Activity Modification• NSAID
OPERATIVE TREATMENT ALGORITHIM
Symptom Treatment
Loose body Arthroscopy
Mild decrease ROM Debridement/capsular release
Impingement OK procedure
Marked decrease ROM & painful arc
Total Elbow Replacement
OK Procedure
• Ingenious operation• Fenestrate olecranon
fossa• Debride anterior &
posterior osteophytes plus remove LB
Total Elbow Replacement 1
Total Elbow Replacement 2
• Indications– Age > 65 years– Extensive OA with painful arc– Discomfort almost constant & esp. at night– sedentary