肘关节骨关节炎 资料

本页面由机器翻译,尚未经临床医生审核。英文版本为权威版本。

您的感受

您可能会感到肘部深处有疼痛感。这种磨损性关节炎通常始于中年,且多见于从事重体力劳动的男性。您可能还会感到僵硬,尤其是在早晨刚醒来时。在使用手臂一段时间后,或者如果您侧卧睡觉压到患侧,疼痛可能会加剧。

您的肘部活动度可能不如以前灵活。您可能会发现难以完全伸直手臂或完全弯曲手臂。简单的日常活动可能会变得困难。例如,将手伸到背后扣内衣或把衬衫塞进裤子里时,可能会感到别扭或疼痛。在活动肘部时,您可能还会感觉到摩擦感或听到咔哒声。在某些情况下,您可能会感到环指和小指有刺痛或麻木感,这表明尺神经因关节变化而受到刺激。

如果您过去曾受过肘部损伤,这些症状可能与该创伤有关。然而,原发性骨关节炎也可能在没有特定损伤的情况下发生。您的外科医生会根据您的年龄、磨损的严重程度以及您对手臂功能的需求来决定最佳的治疗方案。对于许多人来说,非手术治疗是早期管理这些症状的第一步。

实际发生了什么

您的肘关节是上臂骨与前臂骨相接之处。在骨关节炎中,缓冲这些骨骼的光滑软骨会逐渐磨损。这种磨损过程通常始于肱尺关节室,即肘部的主要铰链部分。您可能还会发现桡骨头与肱骨小头相接区域(即肘关节附近)出现间隙变窄。

随着关节发生改变,身体会尝试通过生长额外骨骼来自我修复。这些骨性生长物称为骨赘,可在骨骼末端形成突起。当您伸直手臂时,这些突起可能会相互碰撞。这会形成物理性阻挡,阻止您完全伸直肘部。正是这种机械性干扰导致了您在日常活动中感受到的僵硬和疼痛。

肘关节的稳定性依赖于韧带,这些坚韧的条索状组织像绳索一样将骨骼固定在一起。如果这些韧带变得薄弱或受损,骨骼可能会移位。这种不稳定性会增加关节特定部位的压力,加速磨损。久而久之,这种不稳定与摩擦的循环会导致关节表面进一步退化。

在某些情况下,受伤或手术后,身体可能在关节周围的软组织中形成骨骼。这被称为异位骨化。它可能形成坚硬的屏障,限制您的活动范围,从而加重关节炎本身引起的僵硬。了解这些变化有助于解释为何单纯休息往往不够,以及为何需要针对性治疗以恢复功能。

我们能采取的措施

在洛克汉普顿 Mater 私人医院,Kieran Hirpara 医生针对肘部骨关节炎采取分步计划,以匹配您的日常需求。我们从最简单的选项开始,仅在您需要更多缓解时才进行手术。这种治疗路径让您先尝试低风险的治疗。

您的第一步是自我管理和物理治疗。我们建议您改变手臂的使用方式,以避免引起疼痛的动作。物理治疗师或手部治疗师可以教您温和的锻炼,以保持肘关节顺畅活动。他们还可能使用夹板在休息时支撑关节。请给这种方法几周的时间进行充分尝试。许多人在磨损性关节炎的早期阶段发现,活动方式的改变和引导性锻炼可以减少僵硬和疼痛。

如果仅靠运动不足以缓解症状,我们将讨论药物治疗。这包括止痛药和抗炎药以减轻肿胀。我们还可能提供关节内注射。皮质类固醇注射可以在短时间内减轻炎症和疼痛。透明质酸或富血小板血浆(PRP)注射旨在为关节提供缓冲并支持愈合。这些治疗不能治愈关节炎,但可以帮助您在通过治疗建立力量的同时保持活动能力。

当保守治疗未能带来足够改善时,我们会考虑手术。我们会根据您的年龄、磨损的严重程度以及您对手臂功能的需求进行评估。如果您患有轻度至中度关节炎,我们可能会推荐一种称为清创术的手术。这涉及清除骨刺和游离组织,以改善活动度并减轻疼痛。对于关节严重受损的严重病例,我们会讨论全肘关节置换术或间置成形术。这些选项通过替换或重新覆盖关节表面来恢复功能。在做出决定之前,我们会与您全面审查所有风险和益处。

预期情况

您的肘部磨损性关节炎治疗之旅通常从非手术治疗开始。这是早期症状的标准第一步。您的外科医生会根据您的年龄、磨损的严重程度以及您对手臂功能的需求来定制这一方案。对于许多人来说,这种保守治疗在早期阶段能提供有意义的缓解。

如果症状持续或加重,手术选项将成为讨论的一部分。正确的选择取决于您的关节炎是由既往损伤还是自然磨损引起的。对于轻至中度病例,关节镜下骨关节成形术(清除骨刺并收紧关节囊)是一种安全有效的选择。它通常能改善疼痛和活动度,且并发症风险低或需要进一步手术的可能性小。对于需要此类治疗的患者,开放清创术也能取得类似的效果。

对于严重影响全范围活动的重度病例,可能会讨论关节置换术。全肘关节置换是严重关节炎的一种可行选择,尤其适用于年龄较大或活动量较少的患者。然而,由于并发症发生率较高且耐久性有限,通常不建议活动量大的个体进行此手术。在涉及年轻终末期创伤后关节炎患者的特定病例中,可能会考虑部分置换或韧带重建以恢复稳定性,尽管这些方案的翻修率较高。

恢复过程因您选择的治疗路径而异。在非手术治疗中,您可能会经历缓解期与急性发作期交替的情况。在关节镜清创术后,大多数患者在短中期内的恢复过程顺利,功能和疼痛减轻令人满意。虽然短中期随访之间的活动度可能略有下降,但总体结果仍然有利。开放手术也为大多数患者带来了无痛关节和良好的功能恢复。

最终,当治疗方案与您的具体情况相匹配时,预后是积极的。无论您从保守措施开始还是转向手术,目标都是恢复功能并减轻疼痛。您的外科医生将指导您做出这些选择,确保计划与您的生活方式和长期健康相一致。

何时就诊

若肘部疼痛持续且休息后无改善,请咨询全科医生。若出现无力、不稳或交锁症状,请寻求专科医生评估。影响睡眠或工作的症状也需引起重视。疼痛突然加重是寻求医疗帮助的另一个原因。原发性肘骨关节炎通常表现为疼痛和活动受限。该病主要影响从事重体力劳动的中年男性。肘部外伤史会增加患病风险。年龄较大和男性性别也是重要的危险因素。非手术治疗是早期管理的第一步。在疾病早期,非手术方法可能提供缓解。您的外科医生将根据您的具体情况制定治疗方案。


Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Nonoperative treatment remains the first step in the early management of elbow osteoarthritis [1].
  • Total elbow arthroplasty is a reliable treatment option for elbows severely affected by rheumatoid arthritis, with decreased prevalence of complications, maintenance of excellent pain relief, and functional restoration [17].
  • Total elbow arthroplasty is generally avoided in young, active patients due to poor durability [33].
  • Surgical options for severe elbow arthritis must be tailored to cartilage integrity and bone structure [33].
  • Open capsulectomy and debridement through a medial trans-flexor approach is associated with a low rate of complications and is safe and effective for the treatment of primary osteoarthritis of the elbow [2].
  • Elbow arthroscopic osteocapsular arthroplasty is a safe and efficacious treatment for patients with mild to moderate osteoarthritis [3].
  • Arthroscopic osteocapsular arthroplasty can be recommended for its favorable overall treatment outcomes for elbow osteoarthritis [25].
  • Arthroscopic debridement provides good short-term outcomes in primary elbow osteoarthritis and is associated with a low complication rate [4].
  • Arthroscopic debridement for primary degenerative osteoarthritis results in statistically significant and clinically relevant improvement in elbow range of motion and clinical outcomes with low complication and reoperation rates [14].
  • Computer simulation studies recommend arthroscopic debridement in the surgical management of patients with osteoarthritis of the elbow [6].
  • Both open elbow debridement and the Outerbridge-Kashiwagi (OK) procedure had excellent survivorship until conversion to total elbow arthroplasty and are viable options in the treatment of primary elbow osteoarthritis and post-traumatic cases [11].
  • The Outerbridge-Kashiwagi procedure is an effective and safe way of treating both posttraumatic arthritis and osteoarthritis of the elbow [12].
  • Open and arthroscopic debridement procedures are safe and effective in the treatment of elbow osteoarthritis [21].

Anatomy & Pathophysiology

  • Osteophytic change in primary elbow osteoarthritis occurs predominantly in the ulnohumeral compartment [45].
  • Joint space narrowing in primary elbow osteoarthritis more frequently affects the radiocapitellar articulation [45].
  • Three-dimensional computational models identify unique regions of bony impingement in elbow osteoarthritis, such as between the radial head and a posterior capitellar osteophyte in extension [35].
  • The combination of shoulder, elbow, and knee joint involvement accounts for approximately 70% of the contribution to all variables in the assessment of rheumatoid arthritis using the American College of Rheumatology Core Data Set [43].
  • The addition of wrist and ankle joints to the assessment of rheumatoid arthritis increases the contribution to all variables to approximately 90% [43].

Classification

  • The BM classification system demonstrated substantial intraobserver and interobserver reliability for evaluating radiographic severity of post-traumatic arthritis and primary osteoarthritis of the elbow [20].
  • The HR classification system demonstrated substantial intraobserver and interobserver reliability for evaluating radiographic severity of post-traumatic arthritis and primary osteoarthritis of the elbow [20].
  • The CT-based staging system for primary elbow osteoarthritis was highly reproducible and clinically feasible compared with previous plain radiograph-based staging systems [22].
  • The bony landmarks classification system effectively delineated osteophyte distribution in elbow osteoarthritis patients [36].
  • Both the Larsen and Sharp classifications can reliably be used to evaluate rheumatoid arthritis of the elbow by observers of varying training levels [42].

Clinical Presentation

  • Post-traumatic osteoarthritis of the elbow is an uncommon condition where clinical manifestations often vary from radiological findings [5].
  • Surgical treatment for elbow arthritis is based on disease etiology, severity of degeneration, and patient age [7].
  • The prevalence of primary elbow osteoarthritis in Japanese subjects aged 50-89 years was 25.2%, with most cases being asymptomatic [8].
  • The purpose of the review includes discussing the principles of diagnosis and evaluation for elbow arthritis [9].
  • Patients with either posttraumatic or primary degenerative osteoarthritis can expect satisfactory elbow function and an improvement in pain with little chance of reoperation at the midterm of the follow-up duration [10].
  • The appropriate treatment for elbow arthritis depends on the etiology, severity, patient age, and functional demands [13].
  • The medial approach is effective for the treatment of advanced primary osteoarthritis of the elbow, especially in patients with ulnar nerve symptoms as well as medial osteophytes [15].
  • Male patients with primary elbow osteoarthritis had cartilage loss predominantly in the radiocapitellar articulation [18].
  • Female patients with primary elbow osteoarthritis had similar radiocapitellar and ulnohumeral joint involvement, suggesting more symmetric cartilage wear [18].
  • The prevalence of elbow OA was 55.0% in respondents aged 40 years or older, with a symptomatic prevalence of 22.6% [23].
  • Older age, male sex, and a history of elbow trauma were identified as significant risk factors for elbow OA [23].
  • Treatment of elbow arthritis must be individualized based on etiology, severity, patient age, and functional demands [24].
  • Nonsurgical management may provide relief in early stages of elbow arthritis [24].
  • Surgical options for elbow arthritis range from arthroscopic debridement for pain at motion extremes to total elbow arthroplasty for pain throughout the arc of motion [24].
  • Primary osteoarthritis of the elbow is unique due to relative preservation of articular cartilage and maintenance of joint space with hypertrophic osteophyte formation [26].
  • Osteocapsular debridement is an effective surgical treatment option for patients with symptomatic primary elbow osteoarthritis who have failed conservative management [28].
  • When both the shoulder and elbow are involved, the joint that causes the most pain and disability should be operated on first [30].
  • Arthroscopic osteophyte resection and capsulectomy addresses the pathologic processes associated with arthritis of the elbow and was safe and effective [31].

Investigations

  • Male patients with primary elbow osteoarthritis had cartilage loss predominantly in the radiocapitellar articulation, while female patients had similar radiocapitellar and ulnohumeral joint involvement suggesting more symmetric cartilage wear [18].
  • Both the BM and HR classification systems demonstrated substantial intraobserver and interobserver reliability for evaluating radiographic severity of post-traumatic arthritis and primary osteoarthritis of the elbow [20].
  • CT-based staging system was highly reproducible and clinically feasible, compared with previous plain radiograph-based staging systems, for elbow osteoarthritis [22].
  • CT has greater sensitivity than radiographs for the detection of osteophytes and loose bodies in primary elbow osteoarthritis [49].

Treatment

  • Nonoperative treatment is the first step in the early management of elbow osteoarthritis [1].
  • Capsulectomy and debridement through a medial trans-flexor approach is associated with a low rate of complications and is safe and effective for the treatment of primary osteoarthritis of the elbow [2].
  • Elbow arthroscopic osteocapsular arthroplasty (AOA) is a safe, efficacious treatment for patients with mild to moderate osteoarthritis [3].
  • Arthroscopic treatment of elbow osteoarthritis provides good short-term outcomes in primary elbow osteoarthritis and is associated with a low complication rate [4].
  • Arthroscopic debridement is recommended in the surgical management of patients with osteoarthritis of the elbow based on computer simulation [6].
  • Both open elbow debridement and the Outerbridge-Kashiwagi (OK) procedure had excellent survivorship until conversion to total elbow arthroplasty [11].
  • Open elbow debridement and the OK procedure are viable options in the treatment of primary elbow osteoarthritis and post-traumatic cases [11].
  • The OK procedure is an effective and safe way of treating both posttraumatic arthritis and osteoarthritis of the elbow [12].
  • Elbow arthroscopic debridement for primary degenerative osteoarthritis results in statistically significant and clinically relevant improvement in elbow range of motion and clinical outcomes [14].
  • Elbow arthroscopic debridement for primary degenerative osteoarthritis is associated with low complication and reoperation rates [14].
  • Open and arthroscopic debridement procedures seem to be safe and effective in the treatment of elbow OA [21].
  • Arthroscopic treatment of elbow osteoarthritis significantly improved 6-month clinical results for functional scores, pain, strength and range of motion [38].
  • Surgical debridement is an effective treatment for the disabling symptoms of primary elbow OA with an acceptable complication rate [39].
  • Arthroscopic debridement for elbow osteoarthritis provides satisfactory pain relief, improvement of elbow motion, and good functional outcome [40].

Complications

  • Surgical treatment for elbow arthritis is associated with a low rate of complications when performed via a medial trans-flexor approach for capsulectomy and debridement in primary osteoarthritis [2].
  • Elbow arthroscopic osteocapsular arthroplasty (AOA) is considered a safe treatment for patients with mild to moderate osteoarthritis [3].
  • Arthroscopic treatment of elbow osteoarthritis is associated with a low complication rate [4].
  • Elbow arthroscopic debridement for primary degenerative osteoarthritis results in low complication and reoperation rates [14].
  • Total elbow arthroplasty remains associated with substantial complication and reoperation rates [37].

Recovery

  • Capsulectomy and debridement through a medial trans-flexor approach is associated with a low rate of complications and is safe and effective for primary osteoarthritis of the elbow [2].
  • Elbow arthroscopic osteocapsular arthroplasty (AOA) is a safe and efficacious treatment for patients with mild to moderate osteoarthritis [3].
  • Patients with either posttraumatic or primary degenerative osteoarthritis can expect satisfactory elbow function and an improvement in pain with little chance of reoperation at the midterm follow-up duration after arthroscopic elbow debridement [10].
  • Both open elbow debridement and the OK procedure have excellent survivorship until conversion to total elbow arthroplasty and are viable options for primary elbow osteoarthritis and post-traumatic cases [11].
  • Serial assessment of patients with primary elbow OA who underwent arthroscopic osteocapsular arthroplasty (OCA) showed that clinical outcomes improved from preoperative assessment to short- and medium-term follow-up [27].
  • Range of motion (ROM) decreased between short- and medium-term follow-up in patients with primary elbow OA who underwent arthroscopic OCA [27].
  • Most patients undergoing open debridement and radiocapitellar replacement in primary and post-traumatic arthritis of the elbow had an uneventful postoperative course, a painless elbow joint, and satisfactory functional recovery at short-term follow-up [32].
  • In most cases, elbow function was maintained in the long-term without loosening of the implant in patients with rheumatoid arthritis treated with Kudo type-5 total elbow arthroplasty [16].
  • Long-term follow-up showed acceptable results of the type-3 Kudo total elbow arthroplasty in patients with rheumatoid arthritis [29].
  • The outcome of GSB III total elbow arthroplasty in patients with rheumatoid arthritis tends to deteriorate over time because of loosening [44].
  • Total elbow arthroplasty restored satisfactory supportive range of motion to patients' elbow joints in the course of treatment for rheumatoid arthritis [51].

Key Evidence

  • [L5] Nonoperative treatment remains the first step in the early management of elbow osteoarthritis. [1] (10.2106/jbjs.e.00568)
  • [L4] This approach is associated with a low rate of complications and is safe and effective for the treatment of primary osteoarthritis of the elbow. [2] (10.1016/j.jhsa.2011.07.018)
  • [L4] Elbow AOA is a safe, efficacious treatment for patients with mild to moderate osteoarthritis. [3] (10.1016/j.jhsa.2015.11.018)
  • [L4] This minimally invasive technique provides good short-term outcomes in primary elbow osteoarthritis and is associated with a low complication rate. [4] (10.1016/j.otsr.2019.09.003)
  • [L4] Post-traumatic osteoarthritis of the elbow is an uncommon condition where clinical manifestations often vary from radiological findings. [5] (10.1016/j.otsr.2013.11.004)
  • [L4] The study recommends this technique in the surgical management of patients with osteoarthritis of the elbow. [6] (10.1302/0301-620x.96b2.30714)
  • [L5] Surgical treatment for elbow arthritis is based on disease etiology, severity of degeneration, and patient age. [7] (10.1016/j.jhsa.2007.12.022)
  • [L3] The prevalence of primary elbow osteoarthritis in Japanese subjects aged 50-89 years was 25.2%, with most cases being asymptomatic. [8] (10.1016/j.jse.2021.07.015)
  • [L5] 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. [9] (10.1016/j.jhsa.2022.12.014)
  • [L3] Patients with either pathology can expect satisfactory elbow function and an improvement in pain with little chance of reoperation at the midterm of the follow-up duration. [10] (10.1016/j.jseint.2021.07.018)
  • [L4] Both open elbow debridement and the OK procedure had excellent survivorship until conversion to total elbow arthroplasty and are viable options in the treatment of primary elbow osteoarthritis and post-traumatic cases. [11] (10.1016/j.jse.2022.01.138)
  • [L4] The OK procedure is an effective and safe way of treating both posttraumatic arthritis and osteoarthritis of the elbow. [12] (10.1016/j.jse.2015.11.052)
  • [L5] The appropriate treatment for elbow arthritis depends on the etiology, severity, patient age, and functional demands. [13] (10.1016/j.jhsa.2009.02.019)
  • [L1] Elbow arthroscopic debridement for primary degenerative osteoarthritis results in statistically significant and clinically relevant improvement in elbow range of motion and clinical outcomes with low complication and reoperation rates. [14] (10.1016/j.arthro.2017.08.247)
  • [L4] The medial approach is effective for the treatment of advanced primary osteoarthritis of the elbow, especially in patients with ulnar nerve symptoms as well as medial osteophytes. [15] (10.2106/jbjs.d.02684)
  • [L3] In most cases, elbow function was maintained in the long-term without loosening of the implant. [16] (10.1302/0301-620x.99b6.bjj-2016-1033.r2)
  • [L4] Total elbow arthroplasty has become a reliable treatment option for elbows severely affected by rheumatoid arthritis, with recent reports showing decreased prevalence of complications, maintenance of excellent pain relief, and functional restoration. [17] (10.2106/00004623-199805000-00008)
  • [L3] Male patients with primary elbow osteoarthritis had cartilage loss predominantly in the radiocapitellar articulation, while female patients had similar radiocapitellar and ulnohumeral joint involvement suggesting more symmetric cartilage wear. [18] (10.1177/17585732251327183)
  • [L3] Both the BM and HR classification systems demonstrated substantial intraobserver and interobserver reliability for evaluating radiographic severity of post-traumatic arthritis and primary osteoarthritis of the elbow. [20] (10.1016/j.jse.2014.10.015)
  • [L5] However, from the data we obtained the open and arthroscopic debridement procedures seem to be safe and effective in the treatment of elbow OA. [21] (10.1186/s12891-018-2318-x)
  • [L4] CT-based staging system was highly reproducible and clinically feasible, compared with previous plain radiograph-based staging systems, for elbow osteoarthritis. [22] (10.1016/j.joca.2019.03.004)
  • [L3] The prevalence of elbow OA was 55.0% in respondents aged 40 years or older, with a symptomatic prevalence of 22.6%; older age, male sex, and a history of elbow trauma were identified as significant risk factors. [23] (10.1016/j.jse.2018.02.049)
  • [L5] Treatment of elbow arthritis must be individualized based on etiology, severity, patient age, and functional demands; nonsurgical management may provide relief in early stages, while surgical options range from arthroscopic debridement for pain at motion extremes to total elbow arthroplasty for pain throughout the arc of motion. [24] (10.1016/j.jhsa.2012.12.037)
  • [L4] Arthroscopic osteocapsular arthroplasty can be recommended for its favorable overall treatment outcomes for elbow osteoarthritis. [25] (10.1016/j.jse.2019.09.036)
  • [L4] Primary osteoarthritis of the elbow is unique due to relative preservation of articular cartilage and maintenance of joint space with hypertrophic osteophyte formation. [26] (10.5435/00124635-200802000-00005)
  • [L4] Serial assessment of patients with primary elbow OA who underwent arthroscopic OCA showed that the clinical outcomes improved from preoperative assessment to short- and medium-term follow-up, although ROM decreased between short- and medium-term follow-up. [27] (10.1177/23259671231162398)
  • [L2] Osteocapsular debridement is an effective surgical treatment option for patients with symptomatic primary elbow osteoarthritis who have failed conservative management. [28] (10.1016/j.jse.2020.01.060)
  • [L3] This long-term follow-up study showed acceptable results of the type-3 Kudo total elbow arthroplasty in patients with rheumatoid arthritis. [29] (10.2106/00004623-200110000-00008)
  • [L4] When both the shoulder and elbow are involved, the joint that causes the most pain and disability should be operated on first. [30] (10.2106/00004623-198870010-00031)
  • [L4] This procedure addresses the pathologic processes associated with arthritis of the elbow and was safe and effective in this series. [31] (10.1016/j.jse.2007.04.005)
  • [L4] Most patients had an uneventful postoperative course and have shown a painless elbow joint, with satisfactory functional recovery at short-term follow-up. [32] (10.1016/j.jse.2011.08.071)
  • [L4] Surgical options must be tailored to cartilage integrity and bone structure, with total elbow arthroplasty generally avoided in young, active patients due to poor durability. [33] (10.1016/j.jhsg.2025.100736)
  • [L4] Three-dimensional computational models identified the locations and volumes of bony impingement in patients with osteoarthritis of the elbow and highlighted unique regions of impingement, such as between the radial head and a posterior capitellar osteophyte in extension. [35] (10.1016/j.jhsa.2013.03.035)
  • [L3] The bony landmarks classification system effectively delineated osteophyte distribution in elbow patients. [36] (10.1186/s13018-025-06145-9)
  • [L4] Total elbow arthroplasty remains associated with substantial complication and reoperation rates. [37] (10.1016/j.jhsg.2026.100981)
  • [L3] Arthroscopic treatment of elbow osteoarthritis significantly improved 6-month clinical results for functional scores, pain, strength and range of motion. [38] (10.1016/j.otsr.2019.09.002)
  • [L1] Surgical debridement is an effective treatment for the disabling symptoms of primary elbow OA with an acceptable complication rate. [39] (10.1302/2058-5241.5.190095)
  • [L4] Arthroscopic debridement for elbow osteoarthritis provides satisfactory pain relief, improvement of elbow motion, and good functional outcome. [40] (10.1016/j.jse.2014.01.009)
  • [L4] Both systems can reliably be used to evaluate rheumatoid arthritis of the elbow by observers of varying training levels. [42] (10.1016/j.jse.2016.07.074)
  • [L4] The combination of shoulder, elbow, and knee joints accounted for approximately 70% of the contribution to all the variables, while addition of the wrist and ankle joints increased this value to approximately 90%. [43] (10.1002/art.21589)
  • [L4] However, the outcome tends to deteriorate over time because of loosening, and further follow-up is required to analyze long-term loosening rates. [44] (10.1007/s10165-011-0509-5)
  • [L3] Osteophytic change occurs predominantly in the ulnohumeral compartment of the elbow, whereas joint space narrowing more frequently affects the radiocapitellar articulation. [45] (10.1016/j.jse.2006.08.005)
  • [L1] CT has greater sensitivity than radiographs for the detection of osteophytes and loose bodies in primary elbow osteoarthritis. [49] (10.1016/j.jse.2021.04.001)
  • [L4] In the course of total elbow arthroplasty, satisfactory supportive range of motion was restored to patients' elbow joints. [51] (10.1136/annrheumdis-2014-eular.2916)

References

[1] Management of Elbow Osteoarthritis. The Journal of Bone & Joint Surgery. 2006. DOI: 10.2106/jbjs.e.00568

[2] Capsulectomy and Debridement for Primary Osteoarthritis of the Elbow Through a Medial Trans-Flexor Approach. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2011.07.018

[3] Outcomes of Elbow Arthroscopic Osteocapsular Arthroplasty. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2015.11.018

[4] Arthroscopic treatment of elbow osteoarthritis. Orthopaedics & Traumatology: Surgery & Research. 2019. DOI: 10.1016/j.otsr.2019.09.003

[5] Post-traumatic osteoarthritis of the elbow. Orthopaedics & Traumatology: Surgery & Research. 2014. DOI: 10.1016/j.otsr.2013.11.004

[6] Arthroscopic debridement in the treatment of patients with osteoarthritis of the elbow, based on computer simulation. The Bone & Joint Journal. 2014. DOI: 10.1302/0301-620x.96b2.30714

[7] Surgical Options for the Arthritic Elbow. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2007.12.022

[8] Prevalence and associated factors of primary elbow osteoarthritis in the Japanese general elderly population: a Japanese cohort survey randomly sampled from a basic resident registry. Journal of Shoulder and Elbow Surgery. 2022. DOI: 10.1016/j.jse.2021.07.015

[9] Elbow Arthritis. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2022.12.014

[10] Midterm outcomes and survivorship of arthroscopic elbow debridement: a comparison of posttraumatic versus primary degenerative osteoarthritis. JSES International. 2022. DOI: 10.1016/j.jseint.2021.07.018

[11] Long-term survivorship of open débridement and débridement arthroplasty for elbow arthritis: a retrospective chart review. Journal of Shoulder and Elbow Surgery. 2022. DOI: 10.1016/j.jse.2022.01.138

[12] The outerbridge-kashiwagi procedure for primary degenerative arthritis of the elbow vs. post traumatic arthritis. Journal of Shoulder and Elbow Surgery. 2016. DOI: 10.1016/j.jse.2015.11.052

[13] Elbow Arthritis: Current Concepts. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2009.02.019

[14] 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. DOI: 10.1016/j.arthro.2017.08.247

[15] Débridement Arthroplasty for Primary Osteoarthritis of the Elbow. Journal of Bone and Joint Surgery. 2005. DOI: 10.2106/jbjs.d.02684

[16] Kudo type-5 total elbow arthroplasty for patients with rheumatoid arthritis. The Bone & Joint Journal. 2017. DOI: 10.1302/0301-620x.99b6.bjj-2016-1033.r2

[17] Total Elbow Arthroplasty in Patients Who Have Juvenile Rheumatoid Arthritis. The Journal of Bone & Joint Surgery*. 1998. DOI: 10.2106/00004623-199805000-00008

[18] Sex-related differences in wear patterns in primary elbow osteoarthritis. Shoulder & Elbow. 2025. DOI: 10.1177/17585732251327183

[20] Reliability testing of two classification systems for osteoarthritis and post-traumatic arthritis of the elbow. Journal of Shoulder and Elbow Surgery. 2015. DOI: 10.1016/j.jse.2014.10.015

[21] Treatment of osteoarthritis of the elbow with open or arthroscopic debridement: a narrative review. BMC Musculoskeletal Disorders. 2018. DOI: 10.1186/s12891-018-2318-x

[22] Intraobserver and interobserver reliability of the computed tomography-based radiographic classification of primary elbow osteoarthritis: comparison with plain radiograph-based classification and clinical assessment. Osteoarthritis and Cartilage. 2019. DOI: 10.1016/j.joca.2019.03.004

[23] The prevalence of elbow osteoarthritis in Japanese middle-aged and elderly populations: the relationship between risk factors and function. Journal of Shoulder and Elbow Surgery. 2018. DOI: 10.1016/j.jse.2018.02.049

[24] Elbow Arthritis: Current Concepts. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2012.12.037

[25] Arthroscopic osteocapsular arthroplasty for advanced-stage primary osteoarthritis of the elbow using a computed tomography–based classification. Journal of Shoulder and Elbow Surgery. 2020. DOI: 10.1016/j.jse.2019.09.036

[26] Primary Osteoarthritis of the Elbow: Current Treatment Options. Journal of the American Academy of Orthopaedic Surgeons. 2008. DOI: 10.5435/00124635-200802000-00005

[27] Serial Changes in Clinical Outcomes After Arthroscopic Osteocapsular Arthroplasty for Primary Elbow Osteoarthritis: A Medium-term Follow-up Study. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/23259671231162398

[28] The Clinical Impact of Different Approaches to Osteocapsular Debridement for Primary Osteoarthritis of the Elbow: A Systematic Review. Journal of Shoulder and Elbow Surgery. 2020. DOI: 10.1016/j.jse.2020.01.060

[29] Kudo Total Elbow Arthroplasty in Patients with Rheumatoid Arthritis. The Journal of Bone and Joint Surgery-American Volume. 2001. DOI: 10.2106/00004623-200110000-00008

[30] Arthroplasty of the ipsilateral shoulder and elbow in patients who have rheumatoid arthritis.. The Journal of Bone & Joint Surgery. 1988. DOI: 10.2106/00004623-198870010-00031

[31] Osteoarthritis of the elbow: Results of arthroscopic osteophyte resection and capsulectomy. Journal of Shoulder and Elbow Surgery. 2008. DOI: 10.1016/j.jse.2007.04.005

[32] Open debridement and radiocapitellar replacement in primary and post-traumatic arthritis of the elbow: a multicenter study. Journal of Shoulder and Elbow Surgery. 2012. DOI: 10.1016/j.jse.2011.08.071

[33] Management of Severe Elbow Arthritis in a Young Patient. Journal of Hand Surgery Global Online. 2025. DOI: 10.1016/j.jhsg.2025.100736

[35] Identifying the Location and Volume of Bony Impingement in Elbow Osteoarthritis by 3-Dimensional Computational Modeling. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.03.035

[36] Bony landmarks guided mapping of the osteophytes of the elbow osteoarthritis patients: a three dimensional computed tomograph based study. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06145-9

[37] Total Elbow Arthroplasty Complication, Reoperation, and Revision Rates: A Comparison Between Arthroplasty for Arthritis Versus Fracture. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.100981

[38] Arthroscopic debridement for osteoarthritis of the elbow: Results and analysis of predictive factors. Orthopaedics & Traumatology: Surgery & Research. 2019. DOI: 10.1016/j.otsr.2019.09.002

[39] Arthroscopic and open debridement in primary elbow osteoarthritis: a systematic review and meta-analysis. EFORT Open Reviews. 2020. DOI: 10.1302/2058-5241.5.190095

[40] Arthroscopic débridement for primary osteoarthritis of the elbow: analysis of preoperative factors affecting outcome. Journal of Shoulder and Elbow Surgery. 2014. DOI: 10.1016/j.jse.2014.01.009

[42] Reliability testing of the Larsen and Sharp classifications for rheumatoid arthritis of the elbow. Journal of Shoulder and Elbow Surgery. 2017. DOI: 10.1016/j.jse.2016.07.074

[43] Impact of shoulder, elbow, and knee joint involvement on assessment of rheumatoid arthritis using the American College of Rheumatology Core Data Set. Arthritis Care & Research. 2005. DOI: 10.1002/art.21589

[44] Clinical and radiological results of GSB III total elbow arthroplasty in patients with rheumatoid arthritis. Modern Rheumatology. 2011. DOI: 10.1007/s10165-011-0509-5

[45] Radiographic changes at the elbow in primary osteoarthritis: A comparison with normal aging of the elbow joint. Journal of Shoulder and Elbow Surgery. 2007. DOI: 10.1016/j.jse.2006.08.005

[49] Effectiveness of radiographs and computed tomography in evaluating primary elbow osteoarthritis. Journal of Shoulder and Elbow Surgery. 2021. DOI: 10.1016/j.jse.2021.04.001

[51] AB0306 Does Total Elbow Arthroplasty Improve Disease Activity Scores and HAQ in Patients with Rheumatoid Arthritis Treated with Biologics?. Annals of the Rheumatic Diseases. 2014. DOI: 10.1136/annrheumdis-2014-eular.2916