Arthroscopic elbow joint release with radial head resection arthroplasty: 12 cases

BackgroundElbow arthritis typically affects manual labourers aged 40 to 50 years and usually starts in the lateral compartment. The objective of this study was to evaluate the medium-term clinical, functional, and radiological outcomes in 12 patients after arthroscopic elbow joint release and radial head resection arthroplasty.HypothesisOur main hypothesis was that pre-operative damage to the radio-capitellar joint was associated with poorer clinical outcomes after elbow joint release.Material and methodConsecutive patients treated by a single surgeon at a single centre between July 2006 and May 2014 were studied retrospectively. The 12 patients – 10 males and 2 females with a mean age of 54.5 ± 9.3 years (33–69 years) – had osteoarthritis confined to the radio-capitellar compartment with elbow stiffness and pain and underwent arthroscopic elbow joint release with radial head resection arthroplasty. Among them, 9 had a history of trauma or micro-trauma and 3 had rheumatoid arthritis. The Broberg and Morrey osteoarthritis grade on the pre-operative radiographs was 1 in 4 patients, 2 in 6 patients, and 3 in 2 patients.ResultsMean follow-up was 38.1 ± 33.7 months (5–97). One patient required total elbow arthroplasty. Mean arc of motion was 79.6°±20.5° (30–110) pre-operatively, 123.6 ± 18° (90–140) immediately after surgery, and 109°±11.7° (90–120) at last follow-up. At last follow-up, mean values were 81.4 ± 12.5 (65–100) for the Mayo Elbow Score, 11.1 ± 11.1 (2.3–31.8) for the Quick DASH score, and 1.1 ± 1.6 (0–4) for the visual analogue scale pain score. The radiological assessment at last follow-up showed no evidence of osteoarthritis progression.ConclusionIn our case-series, arthroscopic elbow joint release with radial head resection arthroplasty produced good outcomes with a motion arc greater than 100° and little or no pain after a mean follow-up of 3.1 years.Level of evidenceIV, retrospective study.