Debridement arthroplasty for osteoarthritis of the elbow.

For treatment of osteoarthritis of the elbow, the authors use debridement arthroplasty with a medial or lateral approach. Thirty-eight elbows in 36 patients treated with this procedure were examined. The age of the patients ranged from 20 to 71 years, with a mean age of 41.7 years. Cubital tunnel syndrome was present in 16 of the 38 (42%) elbows. The operations were performed through a lateral approach in four elbows, a lateral approach with medial skin incision for ulnar nerve neurolysis in 16 elbows, a medial approach in 10 elbows, and a medial plus a lateral approach in eight elbows. The followup ranged from 2 years to 12.1 years, with an average of 5.9 years. Complete pain relief or minimal elbow pain was reported in 95% of patients who had surgical treatment. The average gain in motion was 6 degrees extension and 18 degrees flexion. Results for the various surgical approaches did not show a statistically significant difference. Recurrence of bony spurs and ridges was analyzed additionally in 18 selected patients who could be observed more than 5 years after surgery (range, 5-12 years). Redevelopment of bony spurs on the coronoid process and olecranon tip occurred in all 18 patients, but those changes were graded as mild in 13 (74%) patients and moderate in five (16%) patients and were accompanied by no pain or slight pain. Elbow arthroplasty as used by the authors produces stable and reliable results for relief of pain, gains in range of motion, and the absence of recurrence of significant osteoarthritis.