Clinical outcomes of a combined arthroscopic and mini-open Outerbridge-Kashiwagi procedure for elbow osteoarthritis

Background: To evaluate the short-term clinical outcomes of a modified Outerbridge-Kashiwagi (O-K) procedure in the treatment of elbow osteoarthritis.Methods: Between January 2012 and December 2016, 27 patients with elbow osteoarthritis were treated with a modified O-K procedure combining mini-open and arthroscopic technique in our institution. All patients with primary osteoarthritis and post-traumatic degenerative osteoarthritis of the elbow were included in the study if they had undergone the modified O-K procedure. Clinical outcomes were assessed using the visual analog scale (VAS), degree of flexion, extension loss, arc of motion, Mayo Elbow Performance Score (MEPS), and radiographs.Results: Twenty-five patients with a mean age of 47.2 years (range, 21-69 years) at surgery were followed up for a mean of 54.5 months (range, 27-86 months). The VAS improved from 8.0 +/- 1.4 (range, 6-10) preoperatively to 1.3 +/- 1.1 (range, 0-3) at the final follow-up (P < .001), degree of flexion from 115.2 degrees +/- 12.0 degrees (range, 90 degrees-135 degrees) to 130.6 degrees +/- 6.3 degrees (range, 120 degrees-140 degrees) (P < .001), extension loss from 31.2 degrees +/- 15.0 degrees (range, 10 degrees-60 degrees) to 10.2 degrees +/- 7.7 degrees (range, 0 degrees-30 degrees) (P < .001), arc of motion from 84.0 degrees +/- 18.8 degrees (range, 55 degrees-120 degrees) to 120.4 degrees +/- 9.3 degrees (range, 105 degrees-135 degrees) (P < .001), and MEPS from 55.8 +/- 8.1 (range, 40-70) to 88.4 +/- 7.2 (range, 70-100) (P < .001). Radiographs at the final follow-up showed that 9 patients (36%) had significant recurrence of bone formation within the fenestration of the olecranon fossa. One patient developed delayed-onset ulnar neuropathy, with only slight numbness in the ulnar nerve distribution 6 months after surgery.Conclusions: The modified O-K procedure is safe and effective in pain relief and function restoration in patients with elbow osteoarthritis. (C) 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.