This study is a retrospective review of 43 patients (44 elbows) with primary osteoarthritis of the elbow who underwent ulnohumeral debridement. The authors reviewed 35 patients at 3.2 years. Results demonstrate 12 good, 19 fair, and 5 were poor. The procedure was performed as originally described by Outerbridge and Kashiwagi. The authors found that both mechanical symptoms and range of motion were improved post-operatively. Mean elbow motion increased from 39-108 degrees to 27-121 degrees. Despite the improvement in function, 39% had rest pain post-operatively and 27% still had locking post-operatively. A duration of symptoms less than 2 years, a pre-operative pain score of 2-3 (on a scale of 0-3) and the presence of cubital tunnel syndrome were associated with an increased chance of a good outcome. The authors also found that the absence of pre-operative locking was associated with an increased chance of a poor outcome.
This article very accurately indicates the variable results following this procedure. Despite an improved arc of motion, 39% continue to have rest pain and 27% continue to have locking. Joint debridement through a limited posterior ostectomy does not allow complete anterior joint access, including the radiocapitellar articulation and the entire anterior capsule. Procedures using medial and/or lateral approaches to the joint provide much greater exposure. When ulnar nerve symptoms or sensitivity is present, a concomitant ulnar nerve decompression is beneficial, especially in those patients with limited preoperative flexion of the elbow.
Journal of Shoulder and Elbow Surgery