LONG TERM FUNCTIONAL RESULTS OF OUTERBRIDGE-KASHIWAGI PROCEDURE FOR ELBOW ARTHRITIS: 6–13 YEAR FOLLOW-UP

Abstract

Between 1994 and 2006, 83 patients (84 elbows) underwent the Outerbridge-Kashiwagi (OK) procedure by the senior author. Of these, 30 patients with over 5 years follow-up where available for review. There were 24 males and 6 females mean age 59.8 (range 34 – 81). 27 patients had primary osteoarthritis and the rest developed post-traumatic arthritis. Mean duration of symptoms was 25.5 (range 12 – 72) months. 30 patients had more than 5-year follow-up with a mean of 96 months (range 60–150) months. Their mean pre-operative flexion improved from 115° (range 90° – 150°) to 134° (range 100° – 160°) post-operatively (p< 0.001) and mean pre-operative extension deficit improved from 28° (range 10° – 50°) to 13° (range 5° – 30°) post-operatively (p< 0.001). The mean MEPS improved from 52 (range 25 – 70) pre-operatively to 84 (range 55 – 100) post-operatively (p< 0.038). The mean pre-operative DASH score improved from 63 (range 37 – 92) to 41 (range 24 – 75) postoperatively (p< 0.001). The mean pre-operative DEORS improved from 6.3 to 4.9 post-operatively (p< 0.001). Majority of the patients [22 patients (73.3%)] returned to their previous work including all 5 professional sportsmen. There were few complications -2 superficial wound infections, and numbness along ulnar nerve distribution in 1 patient. Of the 17 patients who had recurrence after 5 years, 4 patients had to undergo revision surgery (3 improved). 23 patients (76.6%) were satisfied with the results of the surgery. Conclusions: The OK procedure gives excellent to good results in 70.9% of patients at a mean of 9 years. Both flexion and extension improved significantly with very few complications with this open surgical technique. Although 17 out of 30 patients had recurrence on X ray beyond 5 years, only 4 required revision procedures.