title: Arthroscopic joint debridement and capsular release in primary and post-traumatic elbow osteoarthritis: a retrospective blinded cohort study with minimum 24-month follow-up.
abstract: BACKGROUND
  Elbow osteoarthritis (OA) is a degenerative condition which in the advanced stage can severely impair joint mobility. Conservative treatment remains the first choice; surgery should be considered in case of failure in patients prepared to adhere to a demanding rehabilitation protocol. We assess the effectiveness of arthroscopic joint debridement and capsular release in a series of patients with primary and post-traumatic elbow arthritis.
  
  
  METHODS
  Forty-eight subjects (40 males, eight females; mean age 48 years) with a preoperative diagnosis of primary (19, 40 %) or post-traumatic OA (29, 60 %) were evaluated at a mean follow-up of 44 months. Outcome measures were active range of motion (ROM), pain score, Oxford elbow score (OES), and Mayo elbow performance score (MEPS). OA severity was graded into three classes (I-III) based on X-ray findings. Statistical significance was set at 5 %.
  
  
  RESULTS
  At the final follow-up evaluation, active flexion/extension increased significantly (p < 0.01); pronation and supination improved, but the difference was not significant (p > 0.05). The pain score improved from 7.2 to 4.3 (p < 0.01). Both OES and MEPS improved significantly (p < 0.001). Patients with post-traumatic OA had better ROM (p = 0.0391) and clinical scores (OES, p = 0.011; MEPS, p = 0.010). ROM and clinical scores were lower but not significantly so in class II than in class I patients. A smooth coronoid and olecranon fossa was found in 38 (79 %) patients and a preserved ulnotrochlear joint space in 40 (80 %).
  
  
  CONCLUSIONS
  Elbow OA has become more common as a result of earlier diagnosis and an increased number of acute injuries involving the joint. Arthroscopy is an effective technique to treat OA which provides the best results with the correct indications. Prospective studies are needed to help develop guidelines enabling selection of the best treatment option.
authors.affiliation: Unit of Shoulder and Elbow Surgery, "D. Cervesi" Hospital, Cattolica - AUSL della Romagna Ambito Territoriale di Rimini, 47841, Cattolica, Italy. giovannimerolla@hotmail.com.|"Marco Simoncelli" Biomechanics Laboratory, "D. Cervesi" Hospital, Cattolica - AUSL della Romagna Ambito Territoriale di Rimini, Cattolica, Italy. giovannimerolla@hotmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Merolla
authors.affiliation: Unit of Shoulder and Elbow Surgery, "D. Cervesi" Hospital, Cattolica - AUSL della Romagna Ambito Territoriale di Rimini, 47841, Cattolica, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Buononato
authors.affiliation: Department of Orthopedics and Traumatology, Istituto Chirurgico Ortopedico Traumatologico (ICOT), Latina, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Chillemi
authors.affiliation: Unit of Shoulder and Elbow Surgery, "D. Cervesi" Hospital, Cattolica - AUSL della Romagna Ambito Territoriale di Rimini, 47841, Cattolica, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Paladini
authors.affiliation: Unit of Shoulder and Elbow Surgery, "D. Cervesi" Hospital, Cattolica - AUSL della Romagna Ambito Territoriale di Rimini, 47841, Cattolica, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Porcellini
mesh_terms: D001182:Arthroscopy / Q000379:methods*; D003646:Debridement / Q000379:methods*; D004550:Elbow / Q000000981:diagnostic imaging; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D013997:Time Factors; D000092464:Elbow Injuries
keywords: Arthroscopy; Debridement; Elbow; Osteoarthritis