Arthroscopic management of the arthritic elbow: Indications, technique, and results

Twenty-four patients with painful restricted motion of the elbow joint because of an arthritic process were treated with an arthroscopic modification of the open Outerbridge-Kashiwagi procedure. Average preoperative flexion was to 90° (range 60° to 140°), and average extension loss was −40° (range −5° to −60°). The average total arc of motion was 50°. The procedure consisted of arthroscopic debridement, partial resection of the coronoid and olecranon processes, and fenestration of the olecranon fossa. The radial head was excised arthroscopically in 18 of the 24 patients. All patients were reexamined 24 to 60 months after operation (mean 32 months). All patients had a significant decrease in pain as described by a visual analog scale (preoperative 8.2; postoperative 2.2). Average flexion was to 139° (range 95° to 145°), and average extension loss was −8° (range 0° to 15°). The average arc of motion was 131°, an improvement of 81°. Arthroscopic ulnohumeral arthroplasty provides satisfactory results in terms of pain control and improved motion. The complication rate is comparable to those reported in series of open ulnohumeral arthroplasties. This procedure seems to be a valuable adjunct in the management of the arthritic elbow, serving as an intermediate step between nonoperative management and elbow replacement surgery.