2 The condition, current treatments and procedure
2.1 Rheumatoid arthritis is the most common form of arthritis in the elbow. Osteoarthritis that needs surgery is less common in the elbow than in weight-bearing joints, such as the knee and hip. Symptoms include pain, swelling and stiffness in the elbow.
2.2 Treatment for elbow arthritis depends on the severity of the disease. Conservative treatments include analgesics and corticosteroid injections to relieve pain and inflammation, and physiotherapy and prescribed exercise to improve function and mobility. When symptoms are severe, surgery may be indicated. Options include arthroscopic debridement, interposition arthroplasty, replacement or excision of the radial head, or total elbow replacement.
2.3 Lateral resurfacing of the elbow for arthritis is usually done under general anaesthesia. An incision is made through muscle tendon to access the elbow joint, and the articular surfaces prepared. The capitellum of the humerus is reamed using a surface cutter, and a peg hole is created. A trial component is inserted. A guidewire is inserted into the radial head, then the surface is shaped with a cutter to produce a concave face. A peg hole is then created in the radial head and a trial component inserted. Once the trial components have been tested for stability and range of movement the definitive components are implanted and the joint reduced. The soft tissues are repaired, and the skin is closed with sutures. A cast or splint may be used for 4 to 6 weeks.
2.4 A potential advantage of this procedure over a total elbow replacement is that it preserves the natural inner compartment of the elbow. Movements are therefore likely to be more like a natural elbow joint.