This study examined 32 cadaveric elbows between the ages of 60 and 95 years. They made use of Bulloug's vital staining of the articular cartilage. Specimens were then photographed. The authors then attempted to determine a percentage of overall surface-wear based on the photographs using standard image editing software. Findings demonstrated that the radial head showed the greatest wear at the medial capitellar groove in the anatomical position. The capitellar wear pattern demonstrated that the most significant wear occurred at the medial groove bordering the medial trochlear ridge as well as at the apex of the capitellum. Eighty-five of the articular wear of the humerus was on the capitellum.
This article confirms the clinical findings that the most frequent degenerative changes in the elbow occur at the radiocapitellar joint. The authors postulate a pattern of evolvement that proceeds from the posterior medial aspect of the radial head to the apex of the capitellum. In addition, the authors confirm that despite involvement of the entire lateral compartment, the ulnohumeral and radioulnar articulations are preserved. The findings suggest that surgical decompression of the radiocapitellar articulation may alleviate symptoms in the early osteoarthritic elbow.