Navigation-assisted Debridement Arthroplasty for Osteoarthritis of the Elbow: A Preliminary Report

Abstract

Background Debridement arthroplasty is a widely accepted operative treatment for elbow osteoarthritis. However, it is sometimes difficult to define the extent of appropriate osteophyte resection. In the present study, a navigation system was used to resect the osteophytes. Methods Eight male patients (mean age, 62 years) were enrolled in the present study. When the osteophytes around the olecranon, coronoid and radial fossae of the distal humerus were removed, the operation was monitored using a navigation system. Pre‐ and postoperative clinical and radiographical assessments were performed with a mean follow‐up of 29 months. Results There were no major complications during the operations. Postoperative computed tomography showed that the osteophytes were properly removed. The mean range of motion of the elbow improved from −21° to 110° pre‐operatively to −13° to 130° at the time of follow‐up (p < 0.05). The mean Mayo Elbow Performance Score improved from 75 points to 98 points (p < 0.05) and the mean Disabilities of the Arm, Shoulder and Hand score improved from 24.2 points to 8.7 points (p < 0.05). Conclusions The findings of the present study demonstrate that the osteophytes formed at the distal humerus could be precisely visualized using a navigation system. This system effectively defined the region and depth of the morphological configuration for resection.

Evaluation of a computational model to predict elbow range of motion

“…Such a tool would enable surgeons to focus surgery on only those osteophytes which are actually limiting joint ROM, resulting in a more efficient and potentially less invasive procedure. This technique could also be employed for navigation-assisted debridement such as the technique employed by Ikeda et al [ 7 ].…”

“…Such models would allow pre-operative assessment of which osteophytes actually limit ROM, and the anticipated increase in ROM if those osteophytes were to be resected. Such pre-operative planning would allow for more efficient and possibly less invasive surgical treatment, and may lead to the development of newer navigation-assisted debridement techniques [ 7 ]. Sophisticated models for the prediction of elbow joint kinematics have been reported previously in the literature [ 8–16 ].…”