This study attempted to evaluate the effect of humeral condylar resection on the strength of elbow flexion and extension, forearm rotation, wrist flexion-extension, grip strength and functional outcome following elbow arthroplasty. Sixteen patients were included with intact condyles and 16 patients with resection of the condyles. Twenty-eight patients had either post-traumatic osteoarthritis or distal humeral non-unions, 3 patients had an acute fracture and there was 1 elbow ankylosis. Twenty-eight patients underwent a midline triceps split to gain access to the joint whereas 4 underwent a triceps preserving approach. Overall, there was no significant difference between the two groups with regard to strength of pronation, forearm supination, wrist flexion, wrist extension, grip strength, elbow flexion, and elbow extension. The Mayo Elbow Performance score was also similar between the two groups with 79 points in the intact condylar group compared with 77 points in the group with resection of the condyles.
Considering the common origins of the flexor-pronator and extensor groups are resected during condylar resection, there is theoretical concern of diminished forearm and wrist strength. This study, although of low numbers, does appear to refute this. However, with a mean follow-up of approximately 50 months, the effect of loosening may be difficult to determine from this study. There was a trend towards better motion in the patients with condylar resection than with intact condyles with 12 degrees greater flexion/extension and 23 degrees greater forearm rotation. This was not statistically significant. Although not addressed in this article, since most patients underwent a triceps split to gain access to the joint, condylar resection more easily allows for maintenance of the triceps insertion and potentially could minimize triceps dysfunction. This has recently been shown to be quite common following elbow replacement surgery. However, the long-term effects of condylar resection, decreased distal humeral bone stock and diminished contact between the humeral component and the distal humerus are not known.
J Bone Joint Surg