Purpose
To systematically review the available data with regard to clinical and functional
outcomes of arthroscopic and open debridement for elbow arthritis to determine the
complication rate with transition to arthroscopic surgery.
Methods
Using the Preferred Reporting Items for Systematic Reviews and Meta Analyses protocol,
a systematic review was performed including studies reporting clinical and functional
outcomes following open or arthroscopic debridement of elbow arthritis. The primary
outcome measures analyzed were functional outcome (Mayo Elbow Performance Score),
range of motion, and complication rate. Data were extracted for the whole group and
then compared between the techniques using ranges and forest plots.
Results
In total, 39 level IV and 3 level III studies with 1097 elbows were eligible for inclusion;
684 elbows were treated using an open technique and 413 using an arthroscopic technique.
Regarding functional outcome scores, mean Mayo Elbow Performance Score improved significantly
with comparable magnitude of improvement in both groups (arthroscopic group: range
28-34, open group: range 25-31). Regarding range of motion, mean flexion–extension
arc improved significantly in both groups (arthroscopic group: range 8-26°, open group:
range 13-49°). The open group had a lower preoperative flexion–extension arc (range
63-96) in comparison with the arthroscopic group (range 84-119). The overall incidence
of complications was 5.7% (range 0%-19%) in the arthroscopic group and 6.1% (range
0%-25%) in the open group. The most common complication type was neurologic, with
an incidence of 2.1% (range 0%-8%) in the arthroscopic group and 1.9% (range 0%-12%)
in the open group. The deep infection rate was 0.7% (range 0%-10%) in the open group
with no reported incidence in the arthroscopic group.
Conclusions
This systematic review demonstrated good mid-term functional outcomes following debridement
arthroplasty of the arthritic elbow. There was no increase in complications with an
arthroscopic technique confirming its safety and efficacy.
Level of Evidence
IV, Systematic Review of Level III and IV articles.
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Article info
Publication history
Published online: September 16, 2020
Accepted:
September 3,
2020
Received:
April 18,
2020
See commentary on page 759Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2020 by the Arthroscopy Association of North America
