Article

Purpose: To assess the effectiveness of open and minimally invasive techniques in the debridement of osteoarthritis of the elbow, we compared the Outerbridge-Kashiwagi (O-K) procedure with an arthroscopic modification in which arthroscopic debridement and fenestration of the olecranon fossa was performed. The study took the form of a non randomized control trial in which subjects were allocated to a treatment depending on the hospital of presentation. Materials and Methods: Assessment using the Mayo Clinic elbow function chart enabled comparison of the outcome in 18 cases treated by the O-K procedure and 26 patients treated by arthroscopic debridement and fenestration of the olecranon fossa. Mean follow-up was 35.3 months (minimum 12 months). Of the patients treated by the O-K procedure, 14 were men and 4 were women with a mean age of 55 years. In 83% of patients, the diagnosis was primary osteoarthritis, with the remainder post-traumatic arthritis. The patients treated by arthroscopic debridement and fenestration of the olecranon fossa included 24 men and 2 women with a mean age of 46 years, and a diagnosis of primary osteoarthritis in 91% and post-traumatic arthritis in the remainder. No patients were excluded from the study or refused to be included. Results: Both procedures were shown to be effective, with no major complications. Patients treated by arthroscopic debridement and fenestration of the olecranon fossa achieved better relief of pain (P < .10), whereas those patients undergoing the O-K procedure achieved significantly greater improvement in range of flexion (P < .05). No difference between the procedures in terms of patient-perceived overall effectiveness of the surgery was found. Conclusions: In conclusion, in the treatment of osteoarthritis of the elbow, arthroscopic debridement and fenestration of the olecranon fossa may be a more suitable procedure when painful symptoms predominate. In contrast, the O-K procedure is a significantly better procedure for improving the range of flexion where this is a particular problem.

Langue : ANGLAIS

Identifiant basis : 2000213467