TY - JOUR
T1 - Arthroscopic Debridement for Primary Degenerative Osteoarthritis of the Elbow Leads to Significant Improvement in Range of Motion and Clinical Outcomes
T2 - A Systematic Review
AU - Sochacki, Kyle R.
AU - Jack, Robert A.
AU - Hirase, Takashi
AU - McCulloch, Patrick C.
AU - Lintner, David M.
AU - Liberman, Shari R.
AU - Harris, Joshua D.
N1 - Publisher Copyright:
© 2017 Arthroscopy Association of North America
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2017/12
Y1 - 2017/12
N2 - Purpose The purpose of this investigation was to determine whether arthroscopic debridement of primary elbow osteoarthritis results in statistically significant and clinically relevant improvement in (1) elbow range of motion and (2) clinical outcomes with (3) low complication and reoperation rates. Methods A systematic review was registered with PROSPERO and performed using PRISMA guidelines. Databases were searched for studies that investigated the outcomes of arthroscopic debridement for the treatment of primary osteoarthritis of the elbow in adult human patients. Study methodological quality was analyzed. Studies that included post-traumatic arthritis were excluded. Elbow motion and all elbow-specific patient-reported outcome scores were eligible for analysis. Comparisons between preoperative and postoperative values from each study were made using 2-sample Z-tests (http://in-silico.net/tools/statistics/ztest) using a P value <.05. Results Nine articles (209 subjects, 213 elbows, 187 males, 22 females, mean age 45.7 ± 7.1 years, mean follow-up 41.7 ± 16.3. months; 75% right, 25% left; 79% dominant elbow, 21% nondominant) were analyzed. Elbow extension (23.4°-10.7° Δ 12.7°), flexion (115.9°-128.7° Δ 12.8°), and global arc of motion (94.5°-117.6° Δ 23.1°) had statistically significant and clinically relevant improvement following arthroscopic debridement (P <.0001 for all). There was also a statistically significant (P <.0001) and clinically relevant improvement in the Mayo Elbow Performance Score (60.7-84.6, Δ 23.9) postoperatively. Six patients (2.8%) had postoperative complications. Nine (4.2%) underwent reoperation. Conclusions Elbow arthroscopic debridement for primary degenerative osteoarthritis results in statistically significant and clinically relevant improvement in elbow range of motion and clinical outcomes with low complication and reoperation rates. Level of Evidence Systematic review of level IV studies.
AB - Purpose The purpose of this investigation was to determine whether arthroscopic debridement of primary elbow osteoarthritis results in statistically significant and clinically relevant improvement in (1) elbow range of motion and (2) clinical outcomes with (3) low complication and reoperation rates. Methods A systematic review was registered with PROSPERO and performed using PRISMA guidelines. Databases were searched for studies that investigated the outcomes of arthroscopic debridement for the treatment of primary osteoarthritis of the elbow in adult human patients. Study methodological quality was analyzed. Studies that included post-traumatic arthritis were excluded. Elbow motion and all elbow-specific patient-reported outcome scores were eligible for analysis. Comparisons between preoperative and postoperative values from each study were made using 2-sample Z-tests (http://in-silico.net/tools/statistics/ztest) using a P value <.05. Results Nine articles (209 subjects, 213 elbows, 187 males, 22 females, mean age 45.7 ± 7.1 years, mean follow-up 41.7 ± 16.3. months; 75% right, 25% left; 79% dominant elbow, 21% nondominant) were analyzed. Elbow extension (23.4°-10.7° Δ 12.7°), flexion (115.9°-128.7° Δ 12.8°), and global arc of motion (94.5°-117.6° Δ 23.1°) had statistically significant and clinically relevant improvement following arthroscopic debridement (P <.0001 for all). There was also a statistically significant (P <.0001) and clinically relevant improvement in the Mayo Elbow Performance Score (60.7-84.6, Δ 23.9) postoperatively. Six patients (2.8%) had postoperative complications. Nine (4.2%) underwent reoperation. Conclusions Elbow arthroscopic debridement for primary degenerative osteoarthritis results in statistically significant and clinically relevant improvement in elbow range of motion and clinical outcomes with low complication and reoperation rates. Level of Evidence Systematic review of level IV studies.
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U2 - 10.1016/j.arthro.2017.08.247
DO - 10.1016/j.arthro.2017.08.247
M3 - Review article
C2 - 29100769
AN - SCOPUS:85033726932
SN - 0749-8063
VL - 33
SP - 2255
EP - 2262
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 12
ER -