The clinical impact of arthroscopic vs. open osteocapsular débridement for primary osteoarthritis of the elbow: a systematic review.
Guerrero EM., Bullock GS., Helmkamp JK., Madrid A., Ledbetter L., Richard MJ., Garrigues GE.
BACKGROUND: Primary elbow osteoarthritis (PEOA) is a debilitating disease that can be difficult to treat. Osteocapsular débridement (OD) has been described through various approaches, including arthroscopic and open approaches, with successful outcomes in treating PEOA. There is insufficient evidence in the literature to date to demonstrate the superiority of any approach. The purpose of this review was to compare the clinical results of arthroscopic vs. open OD for PEOA. METHODS: The online databases PubMed, Embase (Elsevier), and Scopus (Elsevier) were searched from inception through April 1, 2018, for clinical studies reporting on OD. Studies were stratified based on an arthroscopic vs. open approach. Weighted means were calculated for surgical and patient-reported outcomes. RESULTS: We included 30 studies, reporting on 871 patients and 887 elbows, with a mean follow-up period of 44.3 ± 25.5 months. Of these studies, 15 (420 elbows) reported on open OD, 14 (456 elbows) reported arthroscopic OD, and 1 reported on a cohort of each approach (open in 5 elbows and arthroscopic in 6). The Mayo Elbow Performance Score improved by 28.6 ± 4.57 in the open group vs. 26.6 ± 7.24 in the arthroscopic group. Flexion improved by 19° ± 6° in the open group and 10° ± 6° in the arthroscopic group. Extension improved by 11° ± 5° in the open group and 11° ± 6° in the arthroscopic group. CONCLUSIONS: Open OD and arthroscopic OD are effective surgical treatment options for patients with symptomatic PEOA, reliably improving flexion, extension, and functional outcome scores with low complication rates.