Ulnohumeral Arthroplasty in the Management of the Arthritic Elbow

Abstract

Background

Osteoarthritis of the elbow is a difficult problem to treat. The results of total joint arthroplasty have historically been poor.

Methods

Seventy-nine patients who underwent ulnohumeral arthroplasty between 1994 and 2002 were included in the study. Fifty-nine elbows in 58 patients were available for clinical assessment. There were 14 females and 44 males with an average age of 63 years (32 to 80) and a mean follow-up of 7.8 years (5 to 12). There were 39 (67%) patients with primary osteoarthritis, 18 (31%) with post-traumatic and 1 patient with post-septic arthritis of the elbow.

Results

Using the visual analogue scale (VAS) (0 to 10), the pain score was seen to improve from 8 (6 to 10) to 3.8 (0 to 9). Twenty six patients (44%) were on minimal or no analgesia. The arc regarding flexion/extension was found to increase by 18°. Twenty-four percent of patients suffered an adverse incident. Radiologically 28 (6%) patients had recurrent bone formation in the olecranon fossa. This however did not correspond to the clinical outcome. Patients with loose bodies seemed to do better in the post-operative phase.

Conclusion

Ulnohumeral arthroplasty has a role in the management of the arthritic elbow as it provides pain relief in the post-operative period. However the improvement in the range of movement is limited particularly with regard to the arc of extension. This improvement in pain appears to diminish with time.