Joint debridement for osteoarthritis of the elbow through a bilateral approach

Abstract

Surgical Principles

There are various surgical procedures for osteoarthritis of the elbow joint, such as, resection arthroplasty, total elbow replacement and joint debridement [2]. The indication for each procedure depends on the activities of the patient as well as the stage of the disease. Resection arthroplasty is indicated for severe osteoarthritis. It provides good mobility and relief of pain but joint instability resulting from this procedure is a definite disadvantage, especially for the manual laborer. Total elbow replacement is also indicated for severe osteoarthritis or rheumatoid arthritis. It provides relatively good stability of the elbow joint, but there is a possibility of loosening of the implants [1, 3]. Total elbow replacement is therefore also contraindicated for a manual laborer. The principle of the joint debridement is to remove the osteophytes, which restrict elbow motion, and to release the contracted capsule in order to improve joint motion and to decrease pain. This procedure is indicated for moderate to severe osteoarthritis. The best indication for this procedure is osteoarthritis of the elbow in active patients or manual laborers. There have been some reports about the joint debridement procedure in which different approaches were used [4, 5]. Ogino developed a joint debridement procedure through a bilateral approach. A salient feature of this procedure is the preservation of the lateral and medial collateral ligaments.