Medium-term results of arthroscopic debridement and capsulectomy for the treatment of elbow osteoarthritis.

Background: We retrospectively reviewed 20 patients (21 elbows) after arthroscopic debridement and capsulectomy of the elbow for primary osteoarthritis. We aimed to see if there was an improvement in pain, function, and range of movement in the medium-term.
Materials and Methods: Outcomes of 20 patients (18 men, 2 women) with primary osteoarthritis of the elbow (21 elbows) operated on by the senior surgeon were reviewed at a mean of 5.5 years postoperatively. Inclusion criteria were patients with undergoing arthroscopic debridement and capsulectomy after failure of previous conservative treatment. Exclusion criteria were patients undergoing additional intra-articular procedures at surgery and patients with post-traumatic or inflammatory arthritis. Mean age was 42 years (range, 22-79 years). Preoperatively, osteoarthritis was classified based on plain x-ray images. Functional outcome was assessed using preoperative and postoperative Disabilities of the Arm, Shoulder and Hand (DASH) scores, Mayo scores, and range of movement.
Results: Radiographically, osteoarthritis was assessed as class I in 9 elbows, class II in 10 elbows, and class III in 3 elbows. There was a mean significant improvement in DASH score from 34.0 to 12.7 (P < .05). This was true for all grades of osteoarthritis and significant for classes II and III (P < .05). Mayo scores postoperatively were "excellent" in 11 elbows, "good" in 5, "fair" in 4, and "poor" in 1. Nineteen of the 20 patients said they would have had the surgery again.
Conclusion: Arthroscopic debridement and capsulectomy is an effective procedure for patients with primary osteoarthritis of the elbow. We propose this may work as a partial neurectomy to denervate pain sensation in the joint.
(Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.)