“…Lim et al reported improvement in pain VAS (0-10) from 4.5 to 2.2 points after the procedure with mean 38 months follow-up. 30 Similarly, Galle et al reported improvement in pain VAS from 6.6 to 1.6 points after surgery. 31 Merolla et al have reported a retrospective cohort of 48 patients with either primary or post-traumatic osteoarthrosis treated with arthroscopic joint debridement and assessed pain VAS at the final follow-up visit at 44 months.…”
Background:
The clinical indications for elbow arthroscopic procedures have expanded through last decades. The aim of the study was to assess the functional results and patient satisfaction after arthroscopic treatment of various elbow conditions after a minimum 5-year follow-up.
Methods:
We conducted a retrospective study of a consecutive patient cohort who had undergone unilateral elbow arthroscopy between 2008 and 2010. The main outcomes were Disabilities of the Arm, Shoulder and Hand (DASH) score and a specific patient-reported outcome measure questionnaire after a minimum 5-year follow-up.
Results:
In total, there were 93 patients in the cohort with different diagnoses. Majority of patients were suffering from elbow osteoarthrosis. After the average follow-up of 72 months (range 60–96 months), the response rate was 67%. Eighty two percent of patients were satisfied with the pain relief and locking of the elbow was relieved in 70% of patients. Elbow range of motion (ROM) improved in 80% of the 55 patients who had a limited ROM before the operation. The overall patient satisfaction after elbow arthroscopic treatment was good. There were no differences in median DASH score between patients with or without post-traumatic condition, but the median DASH score for patients who had severe (grade 3) osteoarthrosis before the operation was significantly worse. There were no major complications reported in this cohort.
Conclusions:
Arthroscopic treatment of various elbow conditions was associated with good patient satisfaction and reduced symptoms without major complications.
Level of Evidence: Level IV, therapeutic case series.
“…Lim et al reported improvement in pain VAS (0-10) from 4.5 to 2.2 points after the procedure with mean 38 months follow-up. 30 Similarly, Galle et al reported improvement in pain VAS from 6.6 to 1.6 points after surgery. 31 Merolla et al have reported a retrospective cohort of 48 patients with either primary or post-traumatic osteoarthrosis treated with arthroscopic joint debridement and assessed pain VAS at the final follow-up visit at 44 months.…”
Background:
The clinical indications for elbow arthroscopic procedures have expanded through last decades. The aim of the study was to assess the functional results and patient satisfaction after arthroscopic treatment of various elbow conditions after a minimum 5-year follow-up.
Methods:
We conducted a retrospective study of a consecutive patient cohort who had undergone unilateral elbow arthroscopy between 2008 and 2010. The main outcomes were Disabilities of the Arm, Shoulder and Hand (DASH) score and a specific patient-reported outcome measure questionnaire after a minimum 5-year follow-up.
Results:
In total, there were 93 patients in the cohort with different diagnoses. Majority of patients were suffering from elbow osteoarthrosis. After the average follow-up of 72 months (range 60–96 months), the response rate was 67%. Eighty two percent of patients were satisfied with the pain relief and locking of the elbow was relieved in 70% of patients. Elbow range of motion (ROM) improved in 80% of the 55 patients who had a limited ROM before the operation. The overall patient satisfaction after elbow arthroscopic treatment was good. There were no differences in median DASH score between patients with or without post-traumatic condition, but the median DASH score for patients who had severe (grade 3) osteoarthrosis before the operation was significantly worse. There were no major complications reported in this cohort.
Conclusions:
Arthroscopic treatment of various elbow conditions was associated with good patient satisfaction and reduced symptoms without major complications.
Level of Evidence: Level IV, therapeutic case series.
“… Improved by 16° MacLean et al [ 17 ] 2013 42 Pain and locking 20 patients 21 elbows arthroscopic debridement 66 (DASH), Mayo, and ROM Measure not reported. unchanged Lim et al(8) 2014 51.4 Terminal pain at flexion and extension with limitation of motion 43 patients 43 elbows Arthroscopic d ebridement 38 (VAS),(MEPI) Decreased from 4.5 to 2.2 mean flexion improved from 103° to 116° Miyake et al [ 34 ] 2014 38 Pain at the endpoints of movement and stiffness, catching or locking 20 patients 20 elbows Arthroscopic debridement 24 to 29 Mayo Elbow Performance Score, Range of motion No measure reported, pain disappeared or decreased post operatively. Flexion PRE OP from 121° to to 130° POST OP Merolla et al [ 35 ] 2015 48 Pain, limited range of motion 48 patients 48 elbows Arthroscopic joint debridement 44 (ROM), pain score, (OES), and (MEPS) Decreased from 7.2 ± 1.6 to 4.3 ± 1.1 ,Flexion PRE OP from 115.73° ± 16.53° to128.75° ± 12.35° POST OP Galle et al [ 36 ] 2016 48 Loss of elbow motion, Pain 46 patients 46 elbows Arthroscopic osteo-capsular arthroplasty 40.8 (VAS), (MEPS), (DASH), (ASES) ASES pain Score post op 40 +/−12 flexion (PRE OP from 126° to 135° POST OP Abbreviations: Range Of Motion( ROM ), Mayo Elbow Performance Score( MEPS ), Disabilities of Arm Shoulder and Hand( DASH ), American Shoulder and Elbow Score( ASES ), Visual Analogue Scale( VAS ), Oxford Elbow Score( OES ), Mayo Elbow Performance Index( MEPI ), Hospital for Special Surgery ( HSS ) elbow scoring system Fig.…”
BackgroundElbow osteoarthritis (OA) is a common disabling condition because of pain and loss of motion. Open and arthroscopic debridement are the preferred treatment, however there is no consensus on which treatment modality is suited to which category of patient or stage of disease. The objective of this study was to narratively review the literature for a more comprehensive understanding of its treatment options and associated outcomes, trying to provide a better treatment plan.MethodsThe PubMed database, EMBASE, Cochrane Library, and Google Scholar were searched, using the keywords (elbow [title/abstract] and osteoarthritis [title/abstract] and (surgery or open or arthroscop* or debridement or ulnohumeral arthroplasty) including all possible studies with a set of inclusion and exclusion criteria.ResultsA total of 229 studies were identified. Twenty-one articles published between 1994 and 2016 satisfied the inclusion and exclusion criteria including 651 elbows in 639 patients. After comparison, mean postoperative improvement in (ROM) was 28.6° and 23.3°,Mayo elbow performance score/index(MEPS/MEPI) 31 and 26.8 and the total complication rate was 37(11.5%), and 18(5.5%) for open and arthroscopic procedure.ConclusionsThis narrative review could not provide an insight on which surgical procedure is superior to the other due to the poor orthopedics literature. However, from the data we obtained the open and arthroscopic debridement procedures seem to be safe and effective in the treatment of elbow OA. The optimal surgical intervention for the treatment of symptomatic elbow OA should be determined depending on patients’ conditions.
“…Moreover, these authors also noted that there were also improvements in the severity of pain and the degree of patient satisfaction. Lim et al 21) also performed a follow-up analysis of 43 patients for a mean period of 38 months and reported that there were significant improvements in pain, range of motion, and functional outcomes. These authors also noted that the postoperative range of motion and functional outcomes were worse particularly in patients with severe restrictions of preoperative range of motion.…”
Section: Treatment Results After Arthroscopic Debridement In Elbow Osmentioning
Although arthroscopic surgery has been used conventionally, it has not been widely adopted yet due to the risks of complications, including nerve damage, technical difficulties, and limited indications. As shown in other joints, however, the use of an arthroscope will gradually increased in the elbow joint ('Arthroscopy always wins'). Herein, arthroscopic treatments and arthroscopic ulnar nerve decompression will be discussed in cases of elbow osteoarthritis.
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