Dealing with the Crooks That Steal Elbow Function

The elbow seems like such a simple joint. It's formed with a hinge that allows it to bend and straighten. But, as anyone with arthritis of the elbow can tell you, things can get very complicated. Pain and loss of motion can occur when there are bone spurs inside the joint. These can break off and float freely in the joint.

Painful joint locking can occur when these pieces of tissue get caught in the joint. The nerves nearby can get pinched or scarred, causing numbness, tingling, and pain. Fortunately, this condition is uncommon.

Middle-aged men who use their arms in a repetitive motion are most often affected. Athletes and people who push themselves in a wheelchair are also susceptible. Constant use of crutches is another risk factor for elbow problems.

Doctors are searching for ways to treat this condition. The goal is to restore motion, improve function, and decrease pain or nerve symptoms. The hope is that the symptoms won't come back later. A study done at the Mayo Clinic has been reported. Forty-six elbows were treated for osteoarthritis with surgery.

During the operation, any bone spurs or loose pieces of tissue were removed. Any nerve not moving freely was released. When the capsule of the joint was bound down, it was cut open or removed. (The capsule is a tightly woven envelope of fibrous tissue that surrounds the joint.)

About 74 per cent of the patients had a satisfactory result. This was based on pain level, motion, and function. In the remaining group, some patients thought they were the same or worse than before the operation. Twenty-eight percent reported ulnar nerve pain and numbness. This is the nerve that goes down the inside edge of the elbow and forearm.

According to doctors at the Mayo Clinic, surgery for elbow osteoarthritis has good results. The majority of patients treated had less pain and more motion after surgery. The symptoms may come back in some patients, but they are less severe. Problems with the ulnar nerve may be a limiting factor in this treatment.

References: Samuel A. Antuna, MD, et al. Ulnohumeral Arthroplasty for Primary Degenerative Arthritis of the Elbow. In The Journal of Bone and Surgery. December 2002. Vol. 84A. No. 12. Pp.2168-2173.