Ulnar nerve decompression with osteocapsular arthroplasty for primary elbow osteoarthritis

Area of Science:

• Orthopedic Surgery
• Upper Extremity Reconstruction
• Osteoarthritis Management

Background:

• Primary elbow osteoarthritis (OA) can present with complex challenges, including ulnar nerve neuropathy and high-grade stiffness.
• Current treatment guidelines for these specific presentations require further refinement.

Purpose of the Study:

• To evaluate the effect of ulnar nerve decompression on outcomes of osteocapsular arthroplasty for primary elbow OA.
• To suggest potential treatment guidelines for elbow OA with concurrent ulnar nerve neuropathy or high-grade stiffness.

Main Methods:

• Retrospective review of 30 patients undergoing primary osteocapsular arthroplasty for elbow OA.
• Patients were categorized into ulnar nerve decompression (UD group, n=11) and non-decompression (Non-UD group, n=19) groups.
• Surgical outcomes assessed via visual analog scale (VAS) for pain, range of motion (ROM), and Mayo Elbow Performance Score (MEPS).

Main Results:

• Both groups showed comparable improvements in MEPS, VAS, and overall ROM arc at final follow-up.
• The UD group demonstrated a significantly greater improvement in ROM arc at the 2-year follow-up compared to the Non-UD group (42 vs 14, p=0.002).

Conclusions:

• Osteocapsular arthroplasty combined with ulnar nerve decompression yields compatible clinical results for elbow OA with ulnar nerve neuropathy or high-grade stiffness.
• This combined approach provides enhanced improvement in the motion arc, supporting its consideration in treatment guidelines.