1. DEGENERATIVE ARTHRITIS of the ELBOW

2. ETIOLOGY Primary Secondary Trauma Fracture Dislocation OCD Sepsis

3. CLINICAL 1 Presentation Male 50-60 Discomfort Stiffness +/- locking & effusions

4. 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

5. INVESTIGATIONS Plain XR AP (ossification fossae) Lateral (osteophytes - coronoid & olecranon) CT scan loose body Arthroscopy

6. NON-OPERATIVE TREATMENT often causes only minor symptoms (esp early) Advice Analgesia Activity Modification NSAID

7. OPERATIVE TREATMENT ALGORITHIM

8. OK Procedure Ingenious operation Fenestrate olecranon fossa Debride anterior & posterior osteophytes plus remove LB

9. Total Elbow Replacement 1

10. Total Elbow Replacement 2 Indications Age > 65 years Extensive OA with painful arc Discomfort almost constant & esp. at night sedentary