Elbow Osteoarthritis: Etiology and Pathogenesis

The muscles that encase the elbow joint exert considerable stress upon it during periods of load bearing, with the potential to reach magnitudes threefold that of the body’s weight in the act of lifting. Under the duress of dynamic loading, these forces might soar to more than six times the body’s weight. Given the elbow joint’s modest contact area, this leads to a substantial burden on the hyaline cartilage, especially pronounced during the axial extension phase. The repetitive onslaught of stress beyond the physiological threshold can precipitate the erosion and fracturing of the cartilage, culminating in the emergence of intra-articular loose bodies and the peripheral proliferation of osteophytes [1, 2]. In the elbow joint, the condition is more commonly characterized by the presence of osteophytes and capsular contracture, while joint narrowing is more frequently observed in other joints. Current studies have found that elbow osteoarthritis appears to begin primarily in the lateral part of the elbow, with erosion of the radial head cartilage occurring earlier than the ulnohumeral joint and slowly moving medial, with the ulnohumeral already involved by the time symptoms of degeneration appear [3].