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

Background: Elbow 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. Hypothesis: Our main hypothesis was that pre-operative damage to the radio-capitellar joint was associated with poorer clinical outcomes after elbow joint release. Material and method: Consecutive 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. Results: Mean follow-up was 38.1 +/- 33.7 months (5-97). One patient required total elbow arthroplasty. Mean arc of motion was 79.6 degrees +20.5 degrees (30-110) pre-operatively, 123.6 + 18 degrees (90-140) immediately after surgery, and 109 degrees +/- 11.7 degrees (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. Conclusion: In 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. (C) 2015 Elsevier Masson SAS. All rights reserved.