Current Concepts|Articles in Press

Elbow Arthritis

Published:February 07, 2023DOI:
      Elbow arthritis is an uncommon condition that can cause debilitating pain, stiffness, or instability. The most common etiologies include rheumatoid arthritis, posttraumatic arthritis, and primary osteoarthritis. Treatment begins with nonsurgical modalities, including activity modification, anti-inflammatories, hand therapy, and corticosteroids. Operative intervention may be considered once nonsurgical management has failed. Surgical treatment depends on the underlying etiology, chief complaint, patient age, and functional demand. Advances in technology, especially arthroscopic techniques, have expanded the treatment options available to surgeons. The goals of treatment include pain relief and restoration of functional range of motion. The purpose of this article is to review the pertinent soft tissue and osseous anatomy, discuss the etiologies, review the principles of diagnosis and evaluation, and finally, study the treatment options for elbow arthritis.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Drossaers-Bakker K.W.
        • Kroon H.M.
        • Zwinderman A.H.
        • Breedveld F.C.
        • Hazes J.M.
        Radiographic damage of large joints in long-term rheumatoid arthritis and its relation to function.
        Rheumatology (Oxford). 2000; 39: 998-1003
        • Lehtinen J.T.
        • Kaarela K.
        • Ikävalko M.
        • et al.
        Incidence of elbow involvement in rheumatoid arthritis. A 15 year endpoint study.
        J Rheumatol. 2001; 28: 70-74
        • Stanley D.
        Prevalence and etiology of symptomatic elbow osteoarthritis.
        J Shoulder Elbow Surg. 1994; 3: 386-389
        • Larsen A.
        • Dale K.
        • Eek M.
        Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films.
        Acta Radiol Diagn (Stockh). 1977; 18: 481-491
        • Morrey B.F.
        • Adams R.A.
        Semiconstrained arthroplasty for the treatment of rheumatoid arthritis of the elbow.
        J Bone Joint Surg Am. 1992; 74: 479-490
        • Broberg M.A.
        • Morrey B.F.
        Results of delayed excision of the radial head after fracture.
        J Bone Joint Surg Am. 1986; 68: 669-674
        • Rettig L.A.
        • Hastings II, H.
        • Feinberg J.R.
        Primary osteoarthritis of the elbow: lack of radiographic evidence for morphologic predisposition, results of operative debridement at intermediate follow-up, and basis for a new radiographic classification system.
        J Shoulder Elbow Surg. 2008; 17: 97-105
        • Jämsen E.
        • Virta L.J.
        • Hakala M.
        • Kauppi M.J.
        • Malmivaara A.
        • Lehto M.U.
        The decline in joint replacement surgery in rheumatoid arthritis is associated with a concomitant increase in the intensity of anti-rheumatic therapy: a nationwide register-based study from 1995 through 2010.
        Acta Orthop. 2013; 84: 331-337
        • Sochacki K.R.
        • Jack II, R.A.
        • Hirase T.
        • et al.
        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; 33: 2255-2262
        • Guerrero E.M.
        • Bullock G.S.
        • Helmkamp J.K.
        • et al.
        The clinical impact of arthroscopic vs. open osteocapsular debridement for primary osteoarthritis of the elbow: a systematic review.
        J Shoulder Elbow Surg. 2020; 29: 689-698
        • Morrissey P.B.
        • Myers R.
        • Houskamp D.
        • Kroonen L.T.
        Fracture risk in ulnohumeral arthroplasty-a biomechanical study.
        J Hand Surg Am. 2018; 43: 675.e1-675.e5
        • Antuña S.A.
        • Morrey B.F.
        • Adams R.A.
        • O’Driscoll S.W.
        Ulnohumeral arthroplasty for primary degenerative arthritis of the elbow: long-term outcome and complications.
        J Bone Joint Surg Am. 2002; 84: 2168-2173
        • Krishnan S.G.
        • Harkins D.C.
        • Pennington S.D.
        • Harrison D.K.
        • Burkhead W.Z.
        Arthroscopic ulnohumeral arthroplasty for degenerative arthritis of the elbow in patients under fifty years of age.
        J Shoulder Elbow Surg. 2007; 16: 443-448
        • Ishii K.
        • Inaba Y.
        • Mochida Y.
        • Saito T.
        Good long-term outcome of synovectomy in advanced stages of the rheumatoid elbow.
        Acta Orthop. 2012; 83: 374-378
        • Tanaka N.
        • Sakahashi H.
        • Hirose K.
        • Ishima T.
        • Ishii S.
        Arthroscopic and open synovectomy of the elbow in rheumatoid arthritis.
        J Bone Joint Surg Am. 2006; 88521525
        • Miyamura S.
        • Lans J.
        • Murase T.
        • Oka K.
        • Chen N.C.
        Degenerative changes in the elbow joint after radial head excision for fracture: quantitative 3-dimensional analysis of bone density, stress distribution, and bone morphology.
        J Shoulder Elbow Surg. 2021; 30: e199-e211
        • Welsink C.L.
        • Lambers K.T.A.
        • van Deurzen D.F.P.
        • Eygendaal D.
        • van den Bekerom M.P.J.
        Total elbow arthroplasty: a systematic review.
        JBJS Rev. 2017; 5: e4
        • Krukhaug Y.
        • Hallan G.
        • Dybvik E.
        • Lie S.A.
        • Furnes O.N.
        A survivorship study of 838 total elbow replacements: a report from the Norwegian Arthroplasty Register 1994-2016.
        J Shoulder Elbow Surg. 2018; 27: 260-269
        • Voloshin I.
        • Schippert D.W.
        • Kakar S.
        • Kaye E.K.
        • Morrey B.F.
        Complications of total elbow replacement: a systematic review.
        J Shoulder Elbow Surg. 2011; 20: 158-168
        • Siala M.
        • Laumonerie P.
        • Hedjoudje A.
        • Delclaux S.
        • Bonnevialle N.
        • Mansat P.
        Outcomes of semiconstrained total elbow arthroplasty performed for arthritis in patients under 55 years old.
        J Shoulder Elbow Surg. 2020; 29: 859-866
        • Larson A.N.
        • Morrey B.F.
        Interposition arthroplasty with an Achilles tendon allograft as a salvage procedure for the elbow.
        J Bone Joint Surg Am. 2008; 90: 2714-2723
        • Blaine T.A.
        • Adams R.
        • Morrey B.F.
        Total elbow arthroplasty after interposition arthroplasty for elbow arthritis.
        J Bone Joint Surg Am. 2005; 87: 286-292
        • Koller H.
        • Kolb K.
        • Assuncao A.
        • Kolb W.
        • Holz U.
        The fate of elbow arthrodesis: indications, techniques, and outcome in fourteen patients.
        J Shoulder Elbow Surg. 2008; 17: 293-306