Ulnohumeral arthroplasty in the management of the arthritic elbow

Description: 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/extensionwas 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.
Anthony Hearnden, Sumedh C. Talwalkar, Niloy Roy, Mwaura Kimani, Michael J. Hayton, Ian A. Trail & John K. Stanley Shoulder & Elbow Volume 1 Issue 2, Pages 95 - 98 Full text