J Korean Orthop Assoc.  2009 Feb;44(1):22-28. 10.4055/jkoa.2009.44.1.22.

Debridement Arthroplasty for Primary Elbow Osteoarthritis

• Kim JW
• Chae SU
• Chun CH
• Lee BC

• KMID: 2186374
• DOI: http://doi.org/10.4055/jkoa.2009.44.1.22

Abstract

PURPOSE: The purpose of this study was to analyze clinical and radiological results after debridement arthroplasty during primary elbow arthroplasty.
MATERIALS AND METHODS
This study involved 25 primary elbow osteoarthritis cases that were treated by debridement arthroplasty from January 1996 to December 2004 with at least a 2 year follow up (mean: 41.3 months). Mean patient age was 45.5 years. Clinical outcomes were analyzed using preoperative and postoperative ranges of motion, Mayo Elbow Performance Scores (MEPS), and Visual Analogue Scale scores. Radiologic analysis was based on plain radiographs.
RESULTS
Average flexion-extension arc improved from 72degrees ROM preoperatively to 110.5degrees postoperatively (p<0.001). Mean MEPS was 89.5 points preoperatively and increased postoperatively (p<0.05). Humeral fenestration size decreased from 27% to 20.5%. Bony spurs of the olecranon and coronoid process recurred in 8 cases. Postoperative LOM was found to be associated with spur recurrence (p<0.05).
CONCLUSION
Debridement arthroplasty may be recommendable for primary elbow osteoarthritis as it reduces pain and improves functional outcomes, including range of motion. Spur recurrence was found to be associated with a reduced range of motion.

Keyword

Elbow; Primary osteoarthritis; Debridement arthroplasty

MeSH Terms

Arthroplasty
Debridement
Elbow
Follow-Up Studies
Humans
Olecranon Process
Osteoarthritis
Range of Motion, Articular
Recurrence

Figure

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  Fig. 1 Intraoperative photograph. The olecranon fossa was fenestrated, anterior loose body was removed, and spurring excised at the coronoid.

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  Fig. 2 The radiologic analysis was performed using postoperative and last follow-up plain radiograpgs. The fenestration percentage was determined using (distance A/length of line B)×100. The humeral fenetration size decreased from 27% to 20.5% at last follow-up.

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  Fig. 3 (A) Preoperative radiograph of a 48-year-old male patient with elbow osteoarthritis: osteophytes and loose bodies were evident in the olecranon fossa, olecranon tip, coronoid fossa, coronoid process. (B) Postoperative radiograph of the same patient after an ulnohumeral arthroplasty procedure: Osteophytes and loose bodies were removed and the olecranon fossa was fenestrated. (C) Last follow up radiograph of the same patient at 5 years postoperatively, showing reduced fenestration and diminished osteophytes of the olecranon fossa and tip.

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