ICL 205: Elbow Arthritis in the Young Athlete-Treatment of Elbow Arthritis in the Overhead Athlete

Video Transcription

Video Summary

Dr. Lyle Koehn discusses elbow arthritis in overhead athletes, focusing primarily on valgus extension overload (VEO) syndrome—a condition caused by repetitive throwing stress leading to posterior medial olecranon osteophytes that impinge the joint and cause pain, loss of velocity, and control. Throwing places significant valgus torque (~64 Nm) on the elbow, likened to holding eight 5-pound bowling balls, stressing the ulnar collateral ligament (UCL), which often shows related injury. Diagnosis relies heavily on history, pain location, and throwing phase.<br /><br />Treatment begins conservatively with rest, strengthening, and mechanical correction before progressing to arthroscopic osteophyte removal. Arthroscopy, though technically demanding with risks of neurovascular injury, is preferred due to less morbidity compared to open surgery. Dr. Koehn emphasizes precise portal placement and careful technique to avoid nerve damage. Several case examples illustrate arthroscopic removal of loose bodies and heterotopic ossification, with generally good return-to-sport outcomes.<br /><br />The talk also highlights olecranon stress fractures caused by repetitive valgus stress, often manifesting as posterolateral elbow pain. These fractures may require surgical fixation with cannulated screws for successful healing. Overall, while arthroscopy improves function and motion in throwing athletes, recurrent osteophyte formation and secondary UCL injury remain challenges. Surgical treatment is often palliative, requiring ongoing management akin to a "100,000-mile tune-up" for the athlete’s elbow.

Asset Caption

Presented by Lyle Cain, MD

Keywords

valgus extension overload

elbow arthritis

overhead athletes

arthroscopic osteophyte removal

ulnar collateral ligament injury

olecranon stress fractures

throwing elbow pain