Treatment options depend on the stage of the disease, prior history, what the patient desires, overall medical condition, and the results of diagnostic X-rays.
For the early stages of osteoarthritis of the elbow, the most common treatment is nonsurgical. This includes oral medications to reduce or alleviate pain, physical therapy, and activity modification.
Corticosteroid injections are sometimes used to treat osteoarthritis symptoms. Steroid medication has typically been used with good results. Although the effects of injections are temporary, they can provide significant pain relief until symptoms progress enough to need additional treatment.
An alternative to steroids has been the injection of hyaluronic acid in various forms, called viscosupplementation.
Viscosupplementation involves injecting substances into the joint to improve the quality of the joint fluid. Complete coverage of this techniuqe can be found in the article titled “Viscosupplementation Treatment for Arthritis.”
When nonsurgical interventions are not enough to control symptoms, surgery may be needed. By the time arthritis can be seen on X-rays, there has been significant wear or damage to the joint surfaces. If the wear or damage is limited, arthroscopy can offer a minimally invasive surgical treatment. It may be an option for patients with earlier stages of arthritis.
Arthroscopy has been shown to provide symptom improvement at least in the short term. It involves removing any loose bodies or inflammatory/degenerative tissue in the joint. It also attempts to smooth out irregular surfaces. Multiple small incisions are used to perform the surgery. It can be done as an outpatient procedure, and recovery is reasonably rapid.
If the joint surface has worn away completely, it is unlikely that anything other than a joint replacement would bring about relief.
There are several different types of elbow joint replacement available.
In appropriately selected patients, the improvement in pain and function can be dramatic. With an experienced surgeon, the results for elbow joint replacement are typically as good as those for hip replacement and knee replacement.
For patients who are too young or too active to have prosthetic joint replacement, there are other reasonably good surgical options. If loss of motion is the primary symptom, the surgeon can release the contracture and smooth out the joint surface. At times, a new surface made from the patient’s own body tissues can be made. These procedures can provide years of symptom improvement.