This review covers evaluation and management of posttraumatic elbow arthritis in young, active patients. It frames treatment around the primary complaint and lays out a stepwise algorithm from nonsurgical care to débridement, resurfacing, and arthroplasty. The central theme is preserving future surgical options while restoring a functional, minimally painful elbow.
Start by localizing the pain, because it sorts the patient into a treatment tier. Terminal pain with a comfortable midarc means extrinsic contracture: think loose bodies and osteophytes, treatable with arthroscopic or open osteocapsular débridement. Pain through the entire arc means a bad bearing surface and points toward resurfacing or arthroplasty.
The governing principle is to preserve future options. Each step, from débridement to interposition to partial arthroplasty, keeps TEA in reserve. TEA is a salvage procedure here, not a first-line choice. Failures concentrate in younger, higher-demand patients, and revision rates reach 37% in those aged 40 or younger.
Two pitfalls to avoid: pain at rest should trigger a workup for infection or nonarticular causes before any surgery, and the ulnar nerve must be addressed, with transposition when there is preoperative neuropathy or flexion under 90°.
This review covers evaluation and management of posttraumatic elbow arthritis in young, active patients. It frames treatment around the primary complaint and lays out a stepwise algorithm from nonsurgical care to débridement, resurfacing, and arthroplasty. The central theme is preserving future surgical options while restoring a functional, minimally painful elbow.
Start by localizing the pain, because it sorts the patient into a treatment tier. Terminal pain with a comfortable midarc means extrinsic contracture: think loose bodies and osteophytes, treatable with arthroscopic or open osteocapsular débridement. Pain through the entire arc means a bad bearing surface and points toward resurfacing or arthroplasty.
The governing principle is to preserve future options. Each step, from débridement to interposition to partial arthroplasty, keeps TEA in reserve. TEA is a salvage procedure here, not a first-line choice. Failures concentrate in younger, higher-demand patients, and revision rates reach 37% in those aged 40 or younger.
Two pitfalls to avoid: pain at rest should trigger a workup for infection or nonarticular causes before any surgery, and the ulnar nerve must be addressed, with transposition when there is preoperative neuropathy or flexion under 90°.