Osteoarthritis of the elbow joint is a disease characterized by degenerative changes in cartilage tissue, leading to deformation and disruption of the congruence of the articular surfaces with the development of osteophytes and synovitis. These phenomena are accompanied by pain and dysfunction of the joint.
Globally, it is diagnosed in approximately 12% of people from the entire population of the Earth. The risk of osteoarthritis increases after 55–60 years of age, and is higher in men than in women.
The disease can develop earlier if a person’s occupation involves heavy physical activity. At risk are athletes, loaders, underground miners, drillers, builders and people in other professions that use heavy physical labor. Pathology leads to a deterioration in the quality of life, sometimes to disability.
Mechanism of development and causes of osteoarthritis
Pathological changes develop as a result of functional overload of the joint: impaired blood circulation and deterioration in the nutrition of cartilage tissue occur. Due to the changes occurring, it becomes thinner and deformed. The cartilage ceases to be elastic, cracks appear, and the articular surfaces acquire a “rough” outline. When moving and putting stress on the joint, discomfort and pain are felt in the elbow, which becomes intense over time.
Such changes may occur as a result of the following factors:
- nutritional imbalance, metabolic disorders;
- excessive physical stress on the joint;
- long-term microtraumatization and joint damage;
- postoperative pathology;
- infectious lesions, especially viral etiology;
- inflammatory processes;
- alcohol intoxication;
- harmful working conditions.
Visual changes in cartilage tissue.
Arthrosis of the elbow joint - what is it?
Arthrosis of the elbow joint
is a pathological disease characterized by negative changes in the cartilage and bone tissue of the joint, resulting from excessive friction and the growth of osteophytes (bone growths).
Degenerative-dystrophic processes are triggered as a result of a lack of joint fluid, which acts as a lubricant.
It is important to note that the etiology of the pathology causes damage not only to cartilage and bone, but also to the periarticular bursa, tendons, ligaments and even muscle tissue.
Poor or late diagnosis, as well as lack of necessary treatment, can cause a large number of physiological disorders and loss of mobility.
Clinic of the disease
Symptoms of osteoarthritis of the elbow joint are quite typical. However, in the early stages of development, the disease may not manifest itself in any way. In some cases, discomfort and crunching in the joint, crepitus during movements are detected.
Painful sensations intensify with exertion, reaching a peak intensity in the evening and subsiding at night during the rest period. The pathology is characterized by “starting” pain, which usually occurs in the morning during the first physical exertion on the elbow joint. There is often swelling in this area, which may be accompanied by increasing pain. In advanced cases, deformation of the elbow is observed, and sometimes hypotrophy of the soft tissues around it.
Periodically, the joint can “jam”: a “blockade” sharp pain occurs with simultaneous immobilization. This phenomenon is caused by the infringement of a section of altered necrotic cartilage between the articular surfaces and is called the “articular mouse.” With subsequent movements, this blockade is removed, at the same time the pain decreases, and the joint gains mobility.
There are three stages of the disease.
Osteoarthritis of the elbow joint, grade 1. This is the initial stage, which usually does not manifest itself in any way and is detected in rare cases during x-rays of the elbow joint. Cartilage tissue becomes less smooth and elastic. The patient feels slight local discomfort and fatigue, and a slight decrease in strength in the joint during exercise.
Osteoarthritis of the elbow joint, grade 2. As the disease progresses, degenerative changes increase, leading to impairment of the functional ability of the elbow. Cartilage tissue begins to deteriorate, the intra-articular gap narrows by more than 50%.
This stage is characterized by:
- crunching and crepitus;
- decreased performance, decreased strength in the joint;
- the appearance of pain during movements and exertion.
With grade 3 osteoarthritis, the patient is bothered by intense pain that occurs with minor movement or load, and the functions of the joint are noticeably impaired. Upon examination, deformation and swelling in the affected area are revealed.
Osteoarthritis of the elbow joint, grade 3, is uncommon and rarely leads to disability, but such cases are not excluded in practice.
According to the degree of limitation of work activity, depending on the stages of osteoarthritis, the classification according to A. I. Nesterov is used:
Table No. 1
| Degree of osteoarthritis | Ability to do work |
| First | Slightly complicates the work process |
| Second | Interferes with the performance of professional duties, especially those associated with heavy physical labor |
| Third | Disability |
Patient complaints
Patients often complain of pain (at the beginning of movements in the joint), progressive limitation of range of motion (deficit of extension), recurrent effusions, a temporary feeling of warming of the joint, and intra-articular crepitus.
If you do not consult a doctor after the appearance of these symptoms, then over time the nutrition of the joint tissues will deteriorate, and degenerative changes in the cartilage will intensify. Even simple work will become impossible when complete deformation of the arm bones occurs. Osteoarthritis of the elbow, as a rule, does not lead to disability, but the patient’s quality of life is greatly deteriorated.
Diagnosis and treatment
The patient is referred to a traumatologist. Diagnosis of the disease begins with examination and questioning of the patient, clarification of complaints, anamnesis, and duration of the disease. During the examination, attention is paid to the appearance of the elbows of both hands, the color of the skin, the presence of swelling, hypertrophy (hypotrophy) of tissues in comparison with a healthy upper limb.
Next, the doctor checks the functionality of the joint, range of motion, the presence of pain in it, and deformation. Restricted mobility in the elbow, up to its complete immobility, signals clear signs of osteoarthritis.
The main diagnostic method is radiography of the elbow joint. If necessary, a computed tomography scan is performed.
Table No. 2. Degrees of osteoarthritis in terms of X-ray picture and treatment effectiveness
| Degree | X-ray picture | Treatment effectiveness |
| First | Small growths of bone tissue (osteophytes) and a slight narrowing of the joint space appear. The beginning of the degeneration of the cartilaginous basis of the joint into bone | It responds well to medication, exercise therapy, and physiotherapy. Sometimes the effect occurs when following a diet, physical activity, or giving up bad habits. |
| Second | Marginal bone growths are clearly visible in the image, the narrowing of the joint space is pronounced | The main focus is on drug (anti-inflammatory and pain) treatment, but previous interventions are also taken into account |
| Third | Significant deformation of the joint, complete or almost complete disappearance of the joint space. Significant bone growths. The intra-articular ligaments are thickened, the amount of synovial fluid is sharply reduced | It is poorly treated with conservative methods. Symptomatic treatment to eliminate pain is mainly used. Surgical methods are effective |
The effect of drug treatment is observed only in the first and second stages of the disease. The third stage implies its symptomatic nature.
Only a doctor can prescribe medications after a detailed examination of the patient. Therapy is selected individually for each person, depending on the stage of the disease and drug tolerance. By using medications yourself, you can harm your health.
Medicines used:
- non-steroidal anti-inflammatory and analgesic drugs: Diclofenac, Voltaren, Ibuprofen, Nimesil, Ketanov, Trigan, Ketorolac;
- hormonal drugs: Hydrocortisone, Kenalog, Dexamethasone;
- chondroprotectors: Mucosat, Chondrolon, Alflutop, Structum.
Such drugs have good medicinal properties, but they give a number of side effects. Therefore, they should be used only according to the clear instructions of a doctor.
For example, long-term use of non-steroidal anti-inflammatory drugs is not recommended due to the harmful effects on the gastrointestinal tract (maximum 2 weeks). Hormones quickly eliminate swelling and inflammation of the elbow, but threaten the appearance of trophic ulcers and other disorders in the body.
Details about NSAIDs:
Non-drug methods
The main methods are physiotherapy, physical therapy, massage, diet. They help very well in the initial stages of the disease and are carried out during periods of remission.
Physiotherapeutic procedures include electrophoresis, magnetic therapy, cryotherapy, laser, darsonvalization, diadynamic currents, etc.
Manual therapy with massage helps to gently and gradually increase the range of motion in the affected limb. Prevents the development of atrophy of the muscles surrounding the joint. Improve blood circulation and eliminate muscle spasms.
A set of exercise therapy exercises is carried out in a medical institution or performed independently by the patient at home. The technique is selected individually by the doctor, and the patient is taught how to perform the exercises.
It is especially important to stick to your diet. Often people suffering from osteoarthritis are overweight. Therefore, review your diet and adhere to the following principles:
- eat in small portions;
- food should not be high in calories (do not abuse carbohydrates, fats, reduce the consumption of baked goods, especially those made from premium flour);
- add vegetables and fruits to your diet;
- reduce consumption of salt and spices;
- give up alcohol.
ethnoscience
Against the background of the main therapy for the first and second stages of the disease, traditional methods can also be used. The use of a salt compress on the affected area (elbow) has gained considerable popularity.
The solution is prepared at the rate of 3 tablespoons of salt per liter of water. A moistened gauze bandage is applied to the elbow joint, tied with a woolen cloth and left overnight. The course is 5-7 such procedures, then a break is taken.
Surgical intervention
At stage 3 of the disease, the patient experiences severe pain, and there is practically no effect from medications. In such circumstances, only surgery will help. Osteotomy is used - excision of the bone at the site of the lesion and fixing it in an advantageous position. If osteophytes are present, they are removed.
In advanced cases, endoprosthesis replacement of the elbow joint or the head of the radial bone is performed. It is indicated for severe contracture or ankylosis (complete immobilization of the elbow). The affected bone areas are excised and a prosthesis is installed in their place. Its parts are attached to the bone tissue of the person being operated on using medical cement.
After such treatment, the patient will have a recovery period, which is carried out in rehabilitation centers or at home under the supervision of a doctor.
Surgery
Surgical intervention is performed if there is no effect from conservative therapy for deforming osteoarthritis of the elbow joint. The main treatment method for DOA is endoprosthetics. It is important to consider that the procedure does not have a lifelong effect; after twenty years the prosthesis will need to be changed.
Surgery is performed in case of ineffective conservative treatment