This study examines the long-tem outcome of debridement arthroplasty for primary osteoarthritis of the elbow. Thirty-three elbows in 32 patients were treated with debridement arthroplasty via a posteromedial approach. An ulnar nerve neurolysis was performed on all patients and an extensive debridement was performed via this incision with a supplemental lateral incision for debridement of the lateral compartment was necessary. The mean age at the time of the operation was 50 years and the mean duration of follow-up was 121 months with 19 elbows followed for more than 10 years. There was a preoperative flexion contracture of 31 degrees, which was reduced to 24 degrees at final follow-up and a preoperative extension contracture of 101 degrees which improved to118 degrees at final follow-up. The mean arc of motion improved by 24 degrees. The mean Japanese Orthopaedic Association Elbow Score improved to 83 points from 60 preoperatively. Seventy-six percent of the patients who performed preoperative heavy manual work returned to their previous or equivalent job. Of the 19 patients evaluated more than 10 years from the operative procedure, the limitation of extension was found to have increased by 7 degrees compared with the limitation noted at 1 year post operatively with the arc of flexion remaining the same. Overall 85% of the patients were satisfied and 3 elbows required revision.
This study reveals a modest improvement in elbow motion in patients treated with debridement arthroplasty for primary osteoarthritis of the elbow. Eighty-five percent of patients had no pain at final follow-up and 5 were only mildly painful. Over the long-term with greater than 10 years follow up, 19 elbows showed only a 5 degree loss of extension with no loss of flexion. This study confirms long-term benefit of debridement arthroplasty for primary ostearthritis of the elbow. It may benefit in preoperative consultation with patients and adds to the literature on the success of the surgical management of elbow arthritis.
J of Bone and Joint Surg