Debridement Arthroplasty for Stiff Elbow

Han, Chung Soo; Rhee, Yong Girl; Jeong, Bi O; Kwon, Boo Kyung

Abstract

PURPOSE
To analyze the clinical results and functional assessments after debridement arthroplasty for a stiff elbow. MATERIALS AND METHODS: 30 elbows from 30 patients, who underwent debridement arthroplasty for a stiff elbow caused by primary osteoarthritis and secondary causes such as post-traumatic osteoarthritis and synovial chondromatosis from December 1995 to April 2003, were analyzed. The mean follow-up period was 52 months (range: 24 months-8 years 5 months). Among the stiff elbows, primary osteoarthritis was the cause in 11 cases, secondary osteoarthritis due to an old trauma was the cause in 18 cases, and synovial chondromatosis was the cause in 1 case. There were 20 males and 10 females with a mean age of 36 years (range: 14-61 years) at operation. They all had pain during elbow motion. Debridement arthroplasty was performed using the posterior approach. The clinical results were evaluated according to differences in the preoperative and postoperative ROM of the elbow and Mayo Elbow Performance Score (MEPS). RESULTS: Postoperatively, the elbow ROM improved to an average 122 degrees(range: 90-130 degrees) in flexion, 11 degrees(range: 0-30 degrees) in extension, 68 degrees(range: 20-90 degrees) in internal rotation and 74 degrees(range: 20-90 degrees) in external rotation. The improvement in flexion and extension was statistically significant (p<0.05). On the final follow-up, only moderate pain was reported in one case and none or mild pain was reported in 29 cases. MEPS improved from an average of 57.3 points (range: 33-75) to 88.9 points (range: 67-100). And there were 17 excellent cases (56.7%), 10 good cases (33.3%), 3 fair cases (10%) and no poor case. CONCLUSION: The stiff elbows were successfully treated with debridement arthroplasty. Therefore, debridement arthroplasty can preserve a good clinical outcomes using skillful surgical procedures and postoperative rehabilitation.