Full Length Article| Volume 35, ISSUE 3, P413-417, July 2022

Download started.


Surgical management of osteoarthritis in the shoulder and elbow

Published:April 12, 2022DOI:


      Interesting recent trends are apparent in the setting of shoulder and elbow pathology. There is an increase in utilization of shoulder arthroplasty for osteoarthritis and post traumatic arthritis. At the same time, there remain limited options for osteoarthritis of the elbow particularly in the young and or active patient. This manuscript details surgical options for osteoarthritis at the elbow and shoulder.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Hand Therapy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Stanley D.
        Prevalence and etiology of symptomatic elbow osteoarthritis.
        J Shoulder Elbow Surg. 1994; 3: 386-389
        • Morrey BF.
        Primary degenerative arthritis of the elbow. Treatment by ulnohumeral arthroplasty.
        J Bone Joint Surg Br. 1992; 74: 409-413
        • Redden JF
        • Stanley D.
        Arthroscopic fenestration of the olecranon fossa in the treatment of osteoarthritis of the elbow.
        Arthroscopy. 1993; 9: 14-16
        • Tsuge K
        • Mizuseki T.
        Debridement arthroplasty for advanced primary osteoarthritis of the elbow. Results of a new technique used for 29 elbows.
        J Bone Joint Surg Br. 1994; 76B: 641-646
        • Antuna SA
        • Morrey BF
        • Adams RA.
        • et al.
        Ulnohumeral arthroplasty for primary degenerative arthritis of the elbow: long-term outcome and complications.
        J Bone Joint Surg Am. 2002; 84A: 2168-2173
        • Adams JE
        • Wolff III, LH
        • Merten SM
        • Steinmann SP
        Osteoarthritis of the elbow: results of arthroscopic osteophyte resection and capsulectomy.
        J Shoulder Elbow Surg. 2008; 17: 126-131
        • Steinmann SP
        • Adams JE.
        Editorial commentary: elbow arthroscopy is a safe procedure. Sure.
        Arthroscopy. 2020; 36 (PMID: 32370891): 1291-1292
        • Cheung EV
        • Adams R
        • Morrey BF
        Primary osteoarthritis of the elbow.
        J Am Acad Orthop Surg. 2008; 16: 77-87
        • Adams JE
        • King GJW
        • Steinmann SP
        • Cohen MS.
        Elbow arthros- copy: indications, techniques, outcomes, and complications.
        J Am Acad Orthop Surg. 2014; 22: 810e818
        • Williams BG
        • Sotereanos DG
        • Baratz ME
        • Jarrett CD
        • Venouziou AI
        • Miller MC
        The contracted elbow: is ulnar nerve release necessary?.
        JShoulder Elbow Surg. 2012;
        • O'Driscoll S
        • Blonna D
        Osteocapsular arthroplasty of the elbow: surgical technique.
        JBJS Essent Surg Tech. 2013; 3: 315
        • O'Driscoll SW
        • Giori NJ
        Continuous passive motion (CPM): theory and principles of clinical application.
        J Rehabil Res Dev. 2000;
        • Kamineni S
        • O'Driscoll SW
        • Urban M
        • et al.
        Intrinsic constraint of unlinked total elbow replacements: the ul- notrochlear joint.
        J Bone Joint Surg Am. 2005; 87: 2019-2027
        • Adams JE
        • Steinmann SP
        Implant options for elbow arthroplasty.
        in: Lee Donald Total Elbow Arthroplasty. ASSH Monograph Series, Chicago, IL2009
        • Welsink CL
        • Lambers KTA
        • van Deurzen DFP
        • et al.
        Total elbow arthroplasty: a systematic review.
        JBJS Rev. 2017; 5: e4
        • McKee MD
        • Veillette CJH
        • Hall JA
        • et al.
        A multicenter, prospective, randomized, controlled trial of open reduction-internal fixation versus total elbow arthroplasty for displaced intra-articular distal humeral fractures in elderly patients.
        J Shoulder Elbow Surg. 2009; 18: 3-12
        • Dehghan N.
        • Furey M
        • Schemitsch L
        • et al.
        Long term outcomes of total elbow arthroplasty for distal humeral fracture: results from a prior randomized clinical trial.
        J Shoulder Elbow Surg. 2019; 28: 2198-2204
        • Frankle MA
        • Herscovici Jr, D
        • DiPasquale TG
        • Vasey MB
        • Sanders RW.
        A comparison of open reduction and internal fixation and primary total elbow arthroplasty in the treatment of intraarticular distal humerus fractures in women older than age 65.
        J Orthop Trauma. 2003; 17: 473-480
        • Kozak TK
        • Adams RA
        • Morrey BF
        To- tal elbow arthroplasty in primary osteoarthritis of the elbow.
        J Arthroplasty. 1998; 13: 837-842
        • Schneeberger AG
        • Meyer DC
        • Yian EH
        Coonrad-Morrey total elbow re- placement for primary and revision surgery: a 2- to 7.5-year follow-up study.
        J Shoulder Elbow Surg. 2007; 16: S47-S54
        • Barlow JD
        • Morrey BF
        • O'Driscoll SW
        • Steinmann SP
        • Sanchez-Sotelo J
        Activities after toal elbow arthroplasty.
        J Shoulder Elbow Surg. 2013; 22: 787-791
        • Morrey BF
        Post-traumatic contracture of the elbow: Operative treat- ment, including distraction arthroplasty.
        J Bone Joint Surg Am. 1990; 72: 601-618
        • Cheng SL
        • Morrey BF
        Treatment of the mobile, painful arthritic elbow by distraction interposition arthroplasty.
        J Bone Joint Surg Br. 2000; 82: 233-238
        • Rybalko DA
        • Hausman MR
        Solutions for the unstable and arthritic elbow joint.
        Hand Clin. 2020; 36: 539-547
        • Reichel LM
        • Wiater BP
        • Friedrich J
        • Hanel DP
        Arthrodesis of the elbow.
        Hand Clin. 2021; 27: 179-186
        • Izquierdo R
        • Voloshin I
        • Edwards S
        • et al.
        American academy of orthopaedic surgeons clinical practice guideline on: the treatment of glenohumeral joint osteoar- thritis.
        J Bone Joint Surg. 2011; 93: 203-205
        • Provencher MT
        • Barker JU
        • Strauss EJ
        • et al.
        Glenohumeral arthritis in the young adult.
        Instr Course Lect. 2011; 60: 137-153
        • Cole BJ
        • Yanke A
        • Provencher MT.
        Nonarthroplasty alternatives for the treatment of glenohumeral arthritis.
        J Shoulder Elbow Surg. 2007; 16: 231-240
        • Bhatia S
        • Hsu A
        • Lin EC
        • et al.
        Surgical treatment options for the young and active middle-aged patient with glenohumeral arthritis.
        Adv Orthop. 2012; 2012846843
        • Cameron BD
        • Galatz LM
        • Ramsey ML
        • et al.
        Non-prosthetic management of grade IV osteochondral lesions of the glenohumeral joint.
        J Shoulder Elbow Surg. 2002; 11: 25-32
        • Weinstein DM
        • Bucchieri JS
        • Pollock RG
        • et al.
        Arthroscopic debridement of the shoulder for osteoarthritis.
        Arthroscopy. 2000; 16: 471-476
        • Van Thiel GS
        • Sheehan S
        • Frank RM
        • et al.
        Retrospective analysis of arthroscopic management of glenohumeral degenerative disease.
        Arthroscopy. 2010; 26: 1451-1455
        • Porcellini G
        • Merolla G
        • Campi F
        • et al.
        Arthroscopic treatment of early glenohum-eral arthritis.
        J Orthop Traumatol. 2013; 14: 23-29
        • Millett PJ
        • Huffard BH
        • Horan MP
        • et al.
        Outcomes of full-thickness articular carti-lage injuries of the shoulder treated with microfracture.
        Arthroscopy. 2009; 25: 856-863
        • Richards DP
        • Burkhart SS.
        Arthroscopic debridement and capsular release for glenohumeral osteoarthritis.
        Arthroscopy. 2007; 23: 1019-1022
        • Snow M
        • Funk L.
        Microfracture of chondral lesions of the glenohumeral joint.
        Int J Shoulder Surg. 2008; 2: 72-76
        • McCarty LP
        • Cole BJ.
        Nonarthroplasty treatment of glenohumeral cartilage le- sions.
        Arthroscopy. 2005; 21: 1131-1142
        • Garretson RB
        • Katolik LI
        • Verma N
        • et al.
        Contact pressure at osteochondral donor sites in the patellofemoral joint.
        Am J Sports Med. 2004; 32: 967-974
        • Scheibel M
        • Bartl C
        • Magosch P
        • et al.
        Osteochondral autologous transplantation for the treatment of full-thickness articular cartilage defects of the shoulder.
        J Bone Joint Surg Br. 2004; 86: 991-997
        • Saltzman BM
        • Riboh JC
        • Cole BJ
        • et al.
        Humeral head reconstruction with osteo- chondral allograft transplantation.
        Arthroscopy. 2015; 31: 1827-1834
        • Riff AJ
        • Yanke AB
        • Shin JJ
        • et al.
        Midterm results of osteochondral allograft trans- plantation to the humeral head.
        J Shoulder Elbow Surg. 2017; 26: e207-e215
        • Steinmann SP
        • Adams JE
        Soft tissue interposition arthroplasty of the shoulder.
        J Shoulder Elbow Surg. 2007; 16: 2545-2605
        • Saltzman MD
        • Mercer DM
        • Warme WJ
        • et al.
        Comparison of patients undergoing primary shoulder arthroplasty before and after the age of fifty.
        J Bone Joint Surg Am. 2010; 92: 42-47
        • Levine WN
        • Fischer CR
        • Nguyen D
        • et al.
        Long-term follow-up of shoulder hemi- arthroplasty for glenohumeral osteoarthritis.
        J Bone Joint Surg Am. 2012; 94: e164
        • Krishnan SG
        • Nowinski RJ
        • Harrison D
        • et al.
        Humeral hemiarthroplasty with bio- logic resurfacing of the glenoid for glenohumeral arthritis. Two to fifteen-year out- comes.
        J Bone Joint Surg Am. 2007; 89: 727-734
        • Iannotti JP
        • Norris TR.
        Influence of preoperative factors on outcome of shoulder arthroplasty for glenohumeral osteoarthritis.
        J Bone Joint Surg Am. 2003; 85-A: 251-258
        • Matsen 3rd, FA
        • Bicknell RT
        • Lippitt SB
        Shoulder arthroplasty: the socket perspective.
        J Shoulder Elbow Surg. 2007; 16: S241-S247
        • Lo IK
        • Litchfield RB
        • Griffin S
        • et al.
        Quality-of-life outcome following hemiarthro- plasty or total shoulder arthroplasty in patients with osteoarthritis. A prospective, randomized trial.
        J Bone Joint Surg Am. 2005; 87: 2178-2185
        • Gartsman GM
        • Roddey TS
        • Hammerman SM.
        Shoulder arthroplasty with or without resurfacing of the glenoid in patients who have osteoarthritis.
        J Bone Joint Surg Am. 2000; 82: 26-34
        • Bryant D
        • Litchfield R
        • Sandow M
        • et al.
        A comparison of pain, strength, range of motion, and functional outcomes after hemiarthroplasty and total shoulder arthro- plasty in patients with osteoarthritis of the shoulder. A systematic review and meta-analysis.
        J Bone Joint Surg Am. 2005; 87: 1947-1956
        • Kim SH
        • Wise BL
        • Zhang Y
        • et al.
        Increasing incidence of shoulder arthroplasty in the United States.
        J Bone Joint Surg Am. 2011; 93: 2249-2254
        • Day JS
        • Lau E
        • Ong KL
        • et al.
        Prevalence and projections of total shoulder and elbow arthroplasty in the United States to 2015.
        J Shoulder Elbow Surg. 2010; 19: 1115-1120
        • Chalmers PN
        • Keener JD.
        Expanding roles for reverse shoulder arthroplasty.
        Curr Rev Musculoskelet Med. 2016; 9: 40-48
        • Trofa D
        • Rajaee SS
        • Smith EL.
        Nationwide trends in total shoulder arthroplasty and hemiarthroplasty for osteoarthritis.
        Am J Orthop. 2014; 43: 166-172

      JHT Read for Credit

      Quiz: # 864

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • # 1.
        OA of the elbow is
        • a.
          more common in females than males
        • b.
          a pure X-ray diagnosis
        • c.
        • d.
          routinely well managed surgically
      • # 2.
        The pain of elbow OA is
        • a.
          generally not experienced in midrange
        • b.
          often worst in midrange
        • c.
          similar in presentation to traumatic arthritis
        • d.
          typically easily managed by routine physical therapy
      • # 3.
        Debridement of the elbow joint is often successful for
        • a.
        • b.
          inflammatory joint disease
        • c.
          generalized OA
        • d.
          patients with loose bodies
      • # 4.
        Interposition arthroplasty is a reasonable approach in
        • a.
          elderly patients with low demand
        • b.
          all age groups
        • c.
          younger patients needing to “buy time”
        • d.
          high demand athletes
      • # 5.
        Currently effective surgical options for the arthritic shoulder outnumber those for the elbow
        • a.
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.