Surgical Treatment of the Primary Osteoarthritis of the Elbow Joint by Modified Outerbridge-Kashiwagi Procedure

Journal of the Korean Society for Surgery of the Hand 2007;12(4):162-169.
Published online December 1, 2007.

Inhyeok Rhyou, Chaeik Chung, Bo Gun Suh, Kyungchul Kim

변형된 Outerbridge-Kashiwagi 술식을 이용한 일차성 주관절염의 수술적 치료

류인혁, 정재익, 서보건, 김경철

Abstract

Purpose
We analyzed the results of modified O-K procedurein patients with primary osteoarthritis of the elbow. Methods: 8 patients with osteoarthritis of the elbow have had modified O-K procedure. The surgical technique included posterior midline skin incision and flap elevation, triceps splitting, excision of osteophytes of coronoid and olecranon and their fossa, anterior and posterior capsulectomy, and anterior transposition of ulnar nerve in cases of preoperative ulnar nerve symptoms. Patients were assessed for pain, range of motion, and functional disability using the Mayo Elbow Performance Score (MEPS) at an average of 15 (6~31) months. Results: The mean arc of flexion-extension improved from 86。(65~110。) preoperatively to 105。(85~125。) (p<0.05) at the last follow up. 7 patients were not painful or mildly painful. According to the MEPS, the results were excellent for 3 patients, good for 3, and fair for 2. Mean MEPS also increased from 65 (55~85) preoperatively to 84 (65~100)(p<0.05). Conclusion: Modified O-K procedure seems to be effective in relieving pain and increasing the arc of flexion-extension in patients of refractory osteoarthritis of the elbow. Cubital tunnel release without anterior transposition of ulnar nerve may be effective for prevention of newly developing ulnar neuropathy.