Elbow

Elbow Arthritis

While the elbow is less commonly affected by arthritis than the hip or knee, elbow arthritis causes significant disability — particularly in patients whose occupations or hobbies demand forceful gripping, lifting, or overhead work. Maryland Orthopedic Specialists offers the full range of interventions, from activity modification and injections to joint-preserving arthroscopic procedures and total elbow arthroplasty.

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What is elbow arthritis?

Elbow arthritis falls into two broad categories: Primary osteoarthritis (OA) is less common than in weight-bearing joints but does occur — typically in middle-aged to older men with a history of heavy manual labor or repetitive loading. The primary OA elbow demonstrates characteristic lateral column pain, loose body formation, and progressive loss of terminal extension due to osteophyte impingement.

Elbow arthritis falls into two broad categories:

Primary osteoarthritis (OA) is less common than in weight-bearing joints but does occur — typically in middle-aged to older men with a history of heavy manual labor or repetitive loading. The primary OA elbow demonstrates characteristic lateral column pain, loose body formation, and progressive loss of terminal extension due to osteophyte impingement. The joint space is often relatively preserved until late disease.

Post-traumatic arthritis follows prior fracture (radial head, distal humerus, coronoid) or dislocation and is the most common cause of elbow arthritis in younger patients. Articular surface incongruity, instability, and post-injury stiffness accelerate cartilage loss.

Inflammatory arthritis — particularly rheumatoid arthritis (RA) — attacks the synovium and can destroy the entire articulation. Patients may present with bilateral involvement, synovitis, and extraarticular features.

Treatment options

Non-operative: Activity modification, NSAIDs, corticosteroid or hyaluronic acid injections, and structured physical therapy targeting ROM and periscapular strengthening. Arthroscopic ulnohumeral arthroplasty / debridement (the "Outerbridge-Kashiwagi" or "elbow arthroscopy"): Loose body removal, osteophyte resection, and capsular release restore functional arc of motion in primary OA with preserved joint space. This is the preferred surgical option for early-to-moderate primary OA. Total elbow arthroplasty (TEA): TEA (e.g., Coonrad-Morrey linked prosthesis) is the gold standard for end-stage RA or severe post-traumatic arthritis in lower-demand patients. A permanent 5 kg lifting restriction preserves implant longevity. TEA provides reliable pain relief and functional restoration in appropriately selected patients.

Non-operative

The majority of patients with elbow arthritis achieve satisfactory symptom control without surgery. Activity modification to avoid repetitive heavy lifting and prolonged end-range flexion or extension reduces mechanical irritation. NSAIDs — oral or topical — manage pain and inflammation, and a brief course of oral corticosteroids can quiet acute flares. Intra-articular corticosteroid injection provides meaningful short-term relief and is particularly useful for inflammatory flares or as a diagnostic tool to confirm the joint as the pain generator. Physical therapy focuses on maintaining range of motion, periscapular strengthening, and activity-specific functional training rather than aggressive joint loading.

Surgical Procedure

Elbow Arthroscopy

Minimally invasive joint scope to address loose bodies, osteochondritis dissecans, posterior impingement, and selected cases of refractory lateral epicondylitis through small portals at the elbow.

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Frequently Asked Questions

Can the elbow wear out like a knee?

Yes. Both primary and post-traumatic arthritis cause progressive cartilage loss, but the elbow's protected geometry means symptoms are often manageable for years with conservative care before surgery is needed.

Is total elbow replacement as reliable as knee replacement?

TEA has excellent outcomes for pain relief in properly selected patients, but the permanent lifting restriction means it is best suited for lower-demand individuals or those with RA.

Are steroid injections safe in the elbow?

Corticosteroid injections provide short- to medium-term relief and are safe when used judiciously (typically no more than 3 per year).

What non-surgical treatments are available for elbow arthritis?

Non-surgical management of elbow arthritis includes activity modification, anti-inflammatory medications, physical therapy to maintain range of motion and muscle strength, and corticosteroid injections for flares of pain and swelling. Bracing or splinting can reduce stress on the joint during demanding activities. Many patients achieve satisfactory pain control and functional levels with these measures alone for years. Your MOS provider will help you identify which combination of treatments best matches your symptoms and daily demands.

What are the surgical options for elbow arthritis, and when should I consider them?

Surgical options range from arthroscopic debridement — removing loose bodies, osteophytes, and inflamed tissue — to total elbow replacement. Arthroscopic procedures work best in earlier-stage arthritis where range of motion is significantly limited by mechanical block or loose bodies. Total elbow replacement is reserved for advanced arthritis with severe pain and functional limitation, particularly in lower-demand patients. At MOS we match the surgical approach to your stage of disease, activity level, and goals, ensuring the most appropriate and durable solution.

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Peter G. Fitzgibbons, MD

Hand Surgery · Orthopedic Surgery

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Related conditions

Posterior Elbow Impingement

Medically reviewed by Peter G. Fitzgibbons, MD, MD

Last reviewed May 1, 2026

References

Cheung EV, Adams R, Morrey BF. Primary osteoarthritis of the elbow: current treatment options. Journal of the American Academy of Orthopaedic Surgeons (JAAOS). 2008;16(2):77–87. https://doi.org/10.5435/00124635-200802000-00004
Morrey BF, Adams RA. Semiconstrained arthroplasty for the treatment of rheumatoid arthritis of the elbow. Journal of Bone and Joint Surgery (JBJS). 1992;74(4):479–490. https://doi.org/10.2106/00004623-199274040-00001
American Academy of Orthopaedic Surgeons. Elbow Arthritis — OrthoInfo. https://orthoinfo.aaos.org/en/diseases--conditions/arthritis-of-the-elbow (accessed May 2026).
Gramstad GD, Galatz LM. Management of elbow osteoarthritis. Journal of Bone and Joint Surgery (JBJS). 2006;88(2):421–430. https://doi.org/10.2106/JBJS.E.00568