Prospective comparative analysis of arthroscopic debridement for primary and post-traumatic elbow osteoarthritis

Abstract

Introduction: The main aim of the present study was to compare the preoperative profiles and the efficacy of arthroscopic debridement for elbow osteoarthritis between patients with primary versus post-traumatic osteoarthritis. The study hypothesis was that the two groups would show no difference on either criterion.

Method: In the framework of a symposium of the French Arthroscopy Society (SFA), a prospective comparative multicenter study included 87 patients with 6 months' follow-up of arthroscopic debridement for elbow osteoarthritis: 53 primary (G1) and 34 secondary (G2). Pre- and post-operative clinical assessment in both groups compared Andrews-Carson specific functional score for elbow osteoarthritis (main endpoint), and the QuickDash (QD), Patient-Related Elbow Evaluation (PREE) and Mayo Elbow Performance Score (MEPS) functional scores, pain on VAS, range of motion (RoM) and strength.

Results: Arthroscopic debridement significantly improved all functional scores at 6 months, notably including the specific Andrews-Carson score, which showed gain in both groups: 68.5±28.7 (range, -5 to 110) in G1 and 62.6±25.4 (18 to 110) in G2 (P=0.35). Pain decreased significantly in both groups, by 5.1±2.6 points (range, 10 to 1) in G1 and 4.4±2.7 points (range, 8.5 to 1) in G2 (P=0.28). RoM in flexion-extension improved comparably in both groups, by 42.9±22.1 (-15 to 105) in G1 and 49.3±24.5 (10 to 90) in G2 (P=0.22). Strength in flexion improved comparably, by 7.6±4.7kg (-2 to 17.5) in G1 and 6.1±4.8kg (-1 to 13) in G2 (P=0.23).

Discussion/conclusion: The study hypothesis was confirmed: there were no differences according to primary versus secondary osteoarthritis in preoperative profile or results. Elbow osteoarthritis entails mechanical impingement. Arthroscopic debridement gave good results independently of primary or post-traumatic etiology.

Level of evidence: III, prospective comparative observational multicenter cohort study.

Keywords: Arthroscopy; Debridement; Elbow; Post-traumatic osteoarthritis; Primary osteoarthritis; Stiffness.