Arthroscopic débridement for primary osteoarthritis of the elbow: analysis of preoperative factors affecting outcome

• Published in: Journal of shoulder and elbow surgery Vol. 23; no. 9; pp. 1381 - 1387
• Main Authors: Lim, Tae Kang, MD, Koh, Kyoung Hwan, MD, Lee, Hyun Il, MD, Shim, Jae Woo, MD, Park, Min Jong, MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01-09-2014
• Subjects: Adult; Aged; Arthroscopy; Debridement; débridement; elbow; Elbow Joint - surgery; Female; Humans; Male; Middle Aged; Orthopedics; osteoarthritis; Osteoarthritis - physiopathology; Osteoarthritis - surgery; Preoperative Period; Range of Motion, Articular; Recovery of Function; Retrospective Studies; Treatment Study; Level IV; elbow; Arthroscopy; Case Series; osteoarthritis; débridement
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2014.01.009

Background The purposes of this study were to evaluate the clinical results of arthroscopic débridement and to identify preoperative factors that influence the outcome. Methods Forty-three elbows with primary osteoarthritis in 43 patients treated with arthroscopic débridement were retrospectively evaluated. At a mean follow-up of 38 months (range, 18-77 months), the visual analog scale (VAS) score for pain, the arc of elbow motion, and the Mayo Elbow Performance Index (MEPI) score were assessed. The relationships between postoperative MEPI score and postoperative motion arc and preoperative factors including age, sex, involvement of the dominant arm, duration of symptoms, demand of elbow activity, VAS score, previous history of failed surgery, and arc of elbow motion were statistically evaluated. Results The mean VAS score for pain, the mean arc of flexion-extension, and the mean MEPI score significantly improved after the operation (all P values < .001). Multivariate regression analysis revealed that among preoperative variables, arc of motion was found to be the only independent prognostic factor that affected both postoperative elbow function ( P  = .024) and final arc of motion ( P  < .001). The cutoff value of preoperative arc of motion for the final arc of motion was determined to be 80° ( P  < .001). Involvement of the dominant arm was found to be another independent factor that affected postoperative MEPI scores ( P  = .016). Conclusions Arthroscopic débridement for elbow osteoarthritis provides satisfactory pain relief, improvement of elbow motion, and good functional outcome. Based on the fact that preoperative motion arc is the independent factor that can predict clinical outcome, arthroscopic treatment is highly recommended for patients who have a motion arc of 80° or more as it yields reliable results.