Joint replacement surgery for elbow tumours: a systematic review of outcomes.

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Abstract

Conflict of interest statement: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. 12. Orthop Traumatol Surg Res. 2019 Dec;105(8S):S235-S240. doi: 10.1016/j.otsr.2019.09.003. Epub 2019 Sep 23. Arthroscopic treatment of elbow osteoarthritis. Desmoineaux P(1), Carlier Y(2), Mansat P(3), Bleton R(4), Rouleau DM(5), Duparc F(6); French Arthroscopic Society(7). Author information: (1)Service de chirurgie orthopédique et traumatologique, hôpital Andre-Mignot, CHR de Versailles, 177, rue de Versailles, 78150 Le Chesnay, France. Electronic address: pdesmoineaux@ch-versailles.fr. (2)Centre de l'Arthrose, clinique du sport Bordeaux Mérignac, 2, rue George-Négrevergne, 33700 Mérignac, France. (3)Département d'orthopédie-traumatologie, hôpital Pierre-Paul-Riquet, clinique universitaire du Sport, CHU-Purpan Toulouse, place du Dr Baylac, 31059 Toulouse, France. (4)Clinique Les Martinets - Ramsay Générale de Santé, 97, avenue Albert 1(er), 92500 Rueil-Malmaison, France. (5)Hôpital du Sacré-Coeur de Montréal, 5400, boulevard Gouin-Ouest, Montréal, QC, Canada. (6)Service de chirurgie orthopédique et traumatologique, CHU Charles-Nicolle, 37, boulevard Gambetta, 76031 Rouen, France. (7)15, rue Ampère, 92500 Rueil-Malmaison, France. Elbow osteoarthritis chiefly affects heavy manual labourers and athletes and may be primary or post-traumatic. Arthroscopic debridement for primary elbow osteoarthritis reliably produces pain relief, motion range gains, and good functional outcomes. Total elbow arthroplasty, in contrast, is considered a salvage option in this patient population, as activities must be restricted to protect the implant. Here, we describe the operative technique used for arthroscopic elbow release in 87 patients with symptomatic elbow osteoarthritis included prospectively at 6 centres in a study that was conducted for a French Arthroscopy Society symposium and whose findings are reported elsewhere. The technique involves exploration of the anterior and posterior compartments with resection of motion-limiting osteophytes; clearing of the fossae; foreign body extraction; and treatment of the posterior and anterior capsule and of the lateral inclines. The indications of ulnar nerve release, radial head excision, release of the posterior band of the medial collateral ligament (MCL), and/or fenestration as described by Outerbridge-Kashiwagi are discussed. After 6 months, 93.5% of patients were satisfied with the procedure. No serious neurological complications were recorded. Wound healing was impaired in 4 patients, of whom 3 responded to local care; the remaining patient required open debridement for surgical-site infection. Complex regional pain syndrome developed in 3 patients. Ulnar nerve transposition was required secondarily in 1 patient and another patient had persistent dysesthesia after ulnar nerve release. This minimally invasive technique provides good short-term outcomes in primary elbow osteoarthritis and is associated with a low complication rate. Copyright © 2019. Published by Elsevier Masson SAS. DOI: 10.1016/j.otsr.2019.09.003