Treatment of primary degenerative arthritis of the elbow by ulnohumeral arthroplasty

Abstract

Between 1990 and 1996 we performed 20 consecutive ulnohumeral arthroplasties for primary osteoarthritis of the elbow. The outcome was assessed using the Disabilities of Arm, Shoulder and Hand Score (DASH) and the Mayo Elbow Performance Score (MEPS) at a mean follow-up of 75 months (58 to 132). There were excellent or good results in 17 elbows (85%) using the DASH score and in 13 (65%) with the MEPS (correlation coefficient 0.79). The mean fixed flexion deformity had improved by 10 degrees and the range of flexion by a mean of 20 degrees. In 16 elbows (80%) the benefits of surgery had been maintained, and of 16 patients working at the time of operation, 12 (75%) had returned to the same job. There was no correlation between radiological recurrence of degenerative changes and the amount of fixed flexion deformity, the flexion arc, or the elbow scores.

Functional outcomes and general health status after ulnohumeral arthroplasty for primary degenerative arthritis of the elbow

“…Several previous studies reported that UHA predictably provides only satisfactory outcomes in short-, mid-, and long-term series using categoric outcome rating scales. 2,13,18 Our categoric outcomes were similar to those in the other studies that used these scoring systems to assess the results.…”

“…Several reports describe satisfactory mid-and long-term results with reduction of pain and functional improvement in a majority of patients after both the OK and UHA procedures. 2,12,13,18 Most of the previous reports of the results after these procedures used either subjective assessment of satisfaction and pain or the Mayo Elbow Performance Score (MEPS). 2,9,12,13 In contrast, the recent focus of clinical orthopaedic research has emphasized patient self-assessment over physician-derived outcome data.…”

“…2,9,[12][13][14]16,18,19 Open debridement was originally described by Kashiwagi 9 in 1978 and was termed the Outerbridge-Kashiwagi (OK) procedure. The technique includes a posterior approach to the elbow with removal of olecranon spurring, transhumeral fenestration, and removal of coronoid spurring.…”

“…9,21 Patientderived outcome scores have been shown to have a higher correlation with patient-perceived function in elbow disorders than most current elbow scoring systems. 21 Nevertheless, only Phillips et al 18 used the DASH questionnaire to evaluate the outcome of UHA. General health status has not been reported after UHA or the OK procedure.…”

Arthroscopy of the Stiff Elbow

“…19,26,34 We approach this strategy with an arthroscopic modification as it was originally described by the senior author (F.H.S.). 30 From the posterocentral portal, a 5 mm pilot hole is drilled through the floor of the olecranon fossa, exiting anteriorly into the coronoid fossa.…”