Source: Lancet  |  Posted 9 years ago

Most patients with elbow osteoarthritis show measurable improvement in pain and function after ulnohumeral arthroplasty, according to a recent British study.

Previous studies have noted improvement in pain, function and range of motion in patients with elbow osteoarthritis after ulnohumeral arthroplasty and related surgical procedures. Unfortunately though, the procedures also resulted in bone formation recurrence.

Further analysis from these studies, however, is limited due to lack of scoring criteria for measuring pain and function and lack of correlation data relating recurrence and outcome.

D. Stanley, FRCS, and colleagues at the Northern General Hospital, Sheffield, England, evaluated post-operative pain and function in 19 patients with elbow osteoarthritis who had undergone ulnohumeral arthroplasty using both subjective and objective measurements. The researchers made their assessments using the Disabilities of Arm, Shoulder and Hand Score (DASH) and the Mayo Elbow Performance Score (MEPS).

About 6 years after surgery, the majority of elbows showed good to excellent results in pain, function and range of motion. Specifically, 65% of elbows fell into this category according to objective measurements and 85% according to subjective patient questionnaires.

Despite radiographic evidence indicating that about half of the patients showed recurrence of bone formation, fixed flexion deformity improved an average of 10 degrees and range of flexion improved by 20 degrees.

This suggests that "radiological evidence of recurrent growth of bone and closure of the fenestration of the olecranon fossa is a poor indicator for assessing the progress of osteoarthritis of the elbow after ulnohumeral arthroplasty," noted Mr. Stanley.

Overall, most patients were satisfied with their outcome, with only 3 patients reporting increased pain or stiffness in the elbow. Additionally, 75% of patients who worked regularly prior to surgery had returned to the same job by their follow up evaluation.