Concierge upper-limb orthopaedics · UK
Elbow open debridement for arthritis, before you consider a replacement.
A motion-preserving operation for active adults with primary elbow osteoarthritis — the OK procedure, the column procedure, and ulnar nerve decompression, done by a consultant elbow surgeon in a proper theatre.
Why patients choose us
- 01
A consultant elbow surgeon, in theatre
A named upper-limb or shoulder-and-elbow consultant who does this operation weekly — not a knee surgeon dipping in.
- 02
Motion-preserving, not replacement
For younger, active patients with primary elbow osteoarthritis, keeping your own joint is usually the right call before a total elbow replacement.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private elbow debridement costs in the UK.
Indicative ranges across our partner hospitals. Send the details and we quote firm figures across two or three consultants.
In short
An OK procedure in our network: £6,500–£9,500, home the next morning.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Outerbridge-Kashiwagi (OK) procedure | £6,500–£9,500 | 60–90 min | 1 night stay |
| Column procedure (lateral or medial) | £7,500–£11,000 | 90–120 min | 1 night stay |
| Open debridement + ulnar nerve decompression | £8,000–£12,000 | 90–120 min | 1 night stay |
| Arthroscopic elbow debridement (alternative) | £6,000–£9,000 | 60–90 min | Day case |
| Consultant elbow consultation + X-rays | £300–£500 | 45 min | Same visit |
| CT elbow (osteophyte mapping) | £450–£700 | 15 min | 48 hours |
Prices vary by hospital, by which consultant does the case, by whether the ulnar nerve is decompressed, and by how many nights of physiotherapy you need. We come back with a firm quote within one working day.
The problem
Not old enough for a replacement, too sore to carry on.
Active adults with primary elbow arthritis often fall in the gap — too active for a total elbow replacement, too painful for anti-inflammatories to hold. Open debridement is the operation designed for exactly that gap.
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Losing terminal extension?
A stiff elbow that will not fully straighten changes how you carry, lift and shake hands — this operation restores much of that arc.
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Pain at end-range only?
Sharp pain at full straightening or full bending is the classic pattern the OK procedure fixes — by removing the bone that is hitting.
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Told you need a replacement?
A second opinion is worth it. If you are under 60 and active, a joint-preserving operation usually comes first.
The journey
From enquiry to recovery — what happens, in order.
One consultant from first message to final review — including the physiotherapy window that decides the result.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
Admission and theatre
Phase 3 · After
Physio, back on
- 01
Before
You tell us what is going on
A short, confidential form. Which elbow, pain pattern, locking, loss of extension or flexion, and how much it stops you doing.
- 02
Before
We come back with a recommendation
Within one working day: the right operation (OK procedure, column debridement or replacement), the right surgeon, an indicative price.
- 03
Before
We arrange imaging and consultation
Plain X-rays as a minimum, often a CT to map osteophytes and loose bodies. Blood thinners are reviewed with the team beforehand.
- 04
On the day
Arrival at the hospital
Admission, consent and a chat with the surgeon and anaesthetist. General anaesthetic, often with a regional block for post-op pain relief.
- 05
On the day
The procedure itself
60 to 120 minutes in a proper theatre. Osteophytes removed, olecranon fossa fenestrated, loose bodies cleared, ulnar nerve decompressed if needed.
- 06
On the day
Overnight stay, then home
Most patients stay one night. Continuous passive motion (CPM) or early physiotherapy starts within 24 hours to protect the gain in movement.
- 07
After
Physio and review
Structured physiotherapy for six to twelve weeks. Consultant review at two and six weeks. Expected arc gain of 20 to 40 degrees over three months.
Typical end-to-end: 3–4 weeks from enquiry to procedure. Full physio: 6–12 weeks.
When it helps
When elbow open debridement is the right step.
The patterns of pain and stiffness we see most, plus the one red flag that means an emergency rather than an appointment.
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Primary elbow osteoarthritis
Wear at the elbow joint — usually in active men over 40 from heavy manual work, throwing sports or weight training.
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Terminal impingement pain
Pain sharp at the very ends of movement — full straightening or full bending — from osteophytes hitting each other.
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Loss of extension or flexion
A stiff elbow that will not fully straighten or bend, typically losing 20 to 40 degrees of the normal arc.
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Locking or catching
Loose bodies (bits of bone or cartilage) that jam the joint intermittently and lock movement.
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Retained cartilage on the joint
Enough good cartilage left on X-ray or CT that a joint-preserving operation makes sense, rather than replacement.
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Younger, high-demand patient
Active adults under 60 for whom a total elbow replacement is not a sensible long-term option because of activity or lifting limits.
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Ulnar nerve symptoms
Tingling in the little and ring fingers from the nerve being stretched over osteophytes — decompressed at the same operation.
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Red flag: sudden hot, swollen elbow
A rapidly swollen, red, hot elbow with fever is not arthritis — it needs same-day A&E to rule out septic arthritis.
Procedure options
One family of operations, several ways in.
What each option on the table actually involves — and which fits your pattern of arthritis.
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Outerbridge-Kashiwagi (OK) procedure
The classic ulnohumeral arthroplasty. Osteophytes at the tip of the olecranon and coronoid are removed and a hole is fenestrated through the olecranon fossa.
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Column procedure (lateral)
Access from the outside of the elbow. Anterior and posterior capsulectomy, radiocapitellar debridement, anterior osteophyte clearance — good for lost extension.
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Column procedure (medial)
Access from the inside. Best when the ulnar nerve needs decompression at the same time, or when medial osteophytes dominate.
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Ulnar nerve decompression
The nerve is released from the cubital tunnel and sometimes transposed. Added when tingling in the little finger is part of the story.
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Arthroscopic debridement
Keyhole clearance of loose bodies and small osteophytes. Faster recovery but less thorough — best for milder disease.
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Radial head excision at same visit
Occasionally the radial head is removed if it is a major source of pain and blocks rotation.
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Total elbow replacement (alternative)
Reserved for older, lower-demand patients or severe joint destruction. A joint-preserving debridement is preferred in the young and active.
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Consultation only
An honest discussion, X-rays and CT if needed, and a clear recommendation — no obligation to proceed.
Our vetted UK network
A small panel of elbow surgeons, we picked them.
BESS-affiliated consultant elbow surgeons in London, Manchester, Birmingham and Edinburgh. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every elbow surgeon in our network.
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Consultant upper-limb or shoulder-and-elbow surgeons, not general orthopaedic trainees
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BESS (British Elbow and Shoulder Society) members with dedicated elbow practice
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On-site physiotherapy with early CPM protocols within 24 hours
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Total elbow replacement capability at the same hospital if a revision is ever needed
Safety and recovery
What to expect afterwards — honestly.
Elbow open debridement is a well-established operation with a good safety record. The things worth planning are the ulnar nerve, the physiotherapy window and knowing what is normal after.
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General anaesthetic, one night in
Almost always done under GA, often with a regional nerve block for the first 12 to 24 hours of pain relief. Most people stay one night.
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Ulnar neuropathy is the main risk
Numbness or tingling in the little finger from stretch or handling of the ulnar nerve. Usually settles, sometimes needs a second small procedure.
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Infection risk is low
Superficial wound infection is uncommon and treated with antibiotics. Deep joint infection is rare but serious.
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Osteophytes can recur
A small number of patients regrow bone spurs over years and need a repeat debridement. Most keep their gain for 10 years or more.
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Pain relief is usually >80%
For the right patient, terminal impingement pain settles substantially. Complete relief is not guaranteed and background ache may persist.
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Immediate motion is essential
Continuous passive motion or self-directed range-of-motion exercises start within 24 hours. Waiting a week loses the gain you just paid for.
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Heterotopic ossification
Extra bone forming in the soft tissues after surgery is uncommon but can limit motion. Prophylaxis is considered case by case.
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Not a total elbow replacement
This operation keeps your own joint. If it fails later, a total elbow replacement remains possible — but the reverse is not true.
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Red flags after surgery
Fever, spreading redness, calf pain or new numbness in the hand need a same-day phone call to the team, not a wait for the review.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the consultant sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Diagnosis and procedure performed
Primary elbow osteoarthritis; which specific operation — OK procedure, lateral or medial column — and any nerve work done.
- 02 Technique
Osteophytes removed and fenestration
Which osteophytes were cleared (coronoid, olecranon, medial or lateral gutter), whether the olecranon fossa was fenestrated, and any loose bodies removed.
- 03 Findings
Cartilage, capsule and nerve
The state of the remaining cartilage, whether the capsule was released, and how the ulnar nerve looked and was managed.
- 04 Impression
Motion gained, physio plan, expectations
Read this first: the arc of movement achieved in theatre, the physiotherapy protocol, and what a realistic long-term outcome looks like for you.
Recognised by major UK insurers
Cover for elbow open debridement is generally straightforward when the operation is medically indicated. We confirm cover, excess and any pre-authorisation before booking.
Frequently asked
Everything we get asked about elbow debridement.
Quick answers on selection, recovery, durability and how it compares with a replacement.
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Am I the right patient for an elbow debridement rather than a replacement?
The classic candidate is an active adult under 60 with primary elbow osteoarthritis, terminal impingement pain, some loss of arc, and retained cartilage on X-ray or CT. If you are older, lower-demand and the joint is destroyed, a total elbow replacement is usually the better answer.
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How much movement will I actually gain?
Most patients gain 20 to 40 degrees of arc — typically split across regaining extension and flexion. The gain shows up in the first three months with proper physiotherapy and then holds.
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How reliable is the pain relief?
Roughly 80 to 90 per cent of appropriately selected patients get substantial relief of their terminal impingement pain. A background ache with heavy activity often remains.
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How long does the result last?
For most patients the improvement lasts ten years or more. A minority regrow osteophytes and need a repeat debridement, and a very few progress to needing a total elbow replacement down the line.
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What is recovery actually like?
One night in hospital, a sling for comfort for a few days, continuous passive motion or active movement starting within 24 hours, and structured physiotherapy for six to twelve weeks. Desk work at two to three weeks, heavy manual work at eight to twelve.
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What is the difference between the OK procedure and a column procedure?
The OK (Outerbridge-Kashiwagi) procedure works through the back of the elbow — it removes the olecranon and coronoid osteophytes and puts a hole through the olecranon fossa. A column procedure works from the side (lateral or medial) and adds capsulectomy and radiocapitellar debridement — more useful when a lot of extension has been lost.
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Is this available on the NHS?
Yes — it is a recognised NHS procedure, done by BESS members in most tertiary upper-limb units. Waiting times vary; private is faster and lets you choose your consultant.
Related treatments
Looking for something else?
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Elbow arthrolysis
Release of a stiff elbow after injury or previous surgery.
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Elbow replacement surgery
Total elbow replacement for severe arthritis in lower-demand patients.
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Elbow physiotherapy
Non-surgical management and post-op rehabilitation.
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All tests and procedures
Every test and procedure we arrange.
Learn more