Abstract
Impingement is a major part of the pathological complex of degenerative osteoarthritis of the elbow. It can be seriously disabling causing symptoms of pain, locking, swelling and reduced range of motion. Various surgical techniques, both arthroscopic as well as open, have been described which aim to remove the offending osteophytes and loose bodies in an attempt to improve elbow function.
Our study includes thirteen patients with a mean age of the 54 years (34 to 68) who underwent debridement arthroplasty of the elbow for degenerative arthritis using a modification of the Outerbridge-Kashiwagi trans-olecranon technique. This approach allows excision of posterior osteophytes, adequate clearance of the olecranon fossa,
removal of anterior coronoid osteophytes and loose bodies via a trans-olecranon fenestration and when required permits decompression of the ulnar nerve in the cubital tunnel.
At a mean follow-up of 37 months (3 to 96) the Mayo scores improved by a mean of 36 points with performance indices being rated as excellent in 5, good in 5 and fair in 3. Pain scores improved by a mean of 4 grades (2 to 8). The mean improvement in the flexion-extension arc was 28 (0 to 55). There was one complication of transient ulnar nerve neuritis, which responded to non-operative measures.
Though limited by the lack of a control group we were able to show the effectiveness and reliability of our technique in producing lasting benefit in improving range of motion and relieving pain in degenerative osteoarthritis of the elbow.
The abstracts were prepared by Wing Commander T. P. S. Bhullar. Correspondence should be addressed to him at the Ministry of Defence Hospital Unit, Edith Cavell Hospital, Bretton Gate, Peterborough PE3 9GZ.
