Arthroscopic osteocapsular arthroplasty combined with mini-open
procedure in elbow osteoarthritis
JG Moon, SK Cheun, HN Kwon.
Korea University Guro Hospital, Seoul, Korea
Background: Primary osteoarthritis of the elbow is characterized by pain,
stiffness with or without ulnar neuropathy. Arthroscopic debridement and
capsulectomy have progressed to become a viable surgical option and reported
satisfactory outcomes. However, posteromedial capsulectomy and ulnar nerve
decompression by arthroscopy are still dangerous and may not be sufficient in
patient with preexisting ulnar nerve symptoms. The purpose of this study is to
evaluate the outcomes of arthroscopic osteocapsular arthroplasty combined with
miniopen ulnar nerve decompression in patients with osteoarthritis of the elbow.
Methods: Sixteen patients with primary osteoarthritis of the elbow were reviewed
at an average of twelve months after operation. The surgical procedure involved
arthroscopic loose bodies removal, excision of olecranon and coronoid
osteophytes and anterior capsulectomy, with miniopen ulnar nerve
decompression and posteromedial capsulectomy. Preoperative and follow-up
assessment included evaluation of elbow pain, range of motion and ulnar nerve
symptom.
Results: The mean VAS score improved from 4.7 (2~8) preoperatively to
1.4(0~3) at the time of follow-up (p < 0.05). The mean preoperative flexion
contracture was 25° and 11° at the final follow-up and mean further flexion
increased from the 110° preoperatively to 134° at the final follow-up. Among the
six patients who had preoperative ulnar nerve symptoms, four patients reported
improvement after surgery. There was no complication related with surgery.
Conclusion: Combined procedure of arthroscopy and mini-open is a safe and
effective procedure for the osteoarthritis arthritis of the elbow.