Degenerative arthritis-of-the-elbow
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Transcript of Degenerative arthritis-of-the-elbow
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DEGENERATIVE ARTHRITIS of the ELBOW
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ETIOLOGY
• Primary• Secondary
– Trauma• Fracture• Dislocation
– OCD– Sepsis
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CLINICAL 1 • Presentation
– Male– 50-60– Discomfort– Stiffness– +/- locking & effusions
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CLINICAL 2 • Pain
– activity related (carrying/throwing) – often localised to olecranon fossa
• Stiffness– Flexion loss (hand to mouth)– Extension loss (little functional problem)
• Locking– characteristic LB
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INVESTIGATIONS
• Plain XR– AP (ossification fossae)– Lateral (osteophytes - coronoid & olecranon)
• CT scan – loose body
• Arthroscopy
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NON-OPERATIVE TREATMENT
• often causes only minor symptoms (esp early)
• Advice• Analgesia• Activity Modification• NSAID
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OPERATIVE TREATMENT ALGORITHIM
Symptom Treatment
Loose body Arthroscopy
Mild decrease ROM Debridement/capsular release
Impingement OK procedure
Marked decrease ROM & painful arc
Total Elbow Replacement
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OK Procedure
• Ingenious operation• Fenestrate olecranon
fossa• Debride anterior &
posterior osteophytes plus remove LB
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Total Elbow Replacement 1
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Total Elbow Replacement 2
• Indications– Age > 65 years– Extensive OA with painful arc– Discomfort almost constant & esp. at night– sedentary
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