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Arthritis
Volume 2013 (2013), Article ID 487615, 11 pages
http://dx.doi.org/10.1155/2013/487615
Review Article

A Literature Synthesis Indicates Very Low Quality, but Consistent Evidence of Improvements in Function after Surgical Interventions for Primary Osteoarthritis of the Elbow

1Faculty of Health Sciences, University of Western Ontario, Elborn College, Room 1424, 1201 Western Road, London, ON, Canada N6G 1H1
2Schools of Physical Therapy and Kinesiology, Faculty of Health Sciences, University of Western Ontario, Room 1400, Elborn College, 1201 Western Road, London, ON, Canada N6G 1H1
3School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada L8S 1C7
4The Hand and Upper Limb Center, St. Joseph’s Hospital, 268 Grosvenor Street, London, ON, Canada N6A 4L6

Received 10 August 2012; Accepted 29 November 2012

Academic Editor: Changhai Ding

Copyright © 2013 Joshua I. Vincent et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Primary osteoarthritis of the elbow is a debilitating disease with an overall incidence of about 2%. Pain and reduced motion (ROM) lead to disability and loss of functional independence. Purpose. To critically review the literature on patient-related important functional outcomes (pain, ROMs and functional recovery) after surgery for primary OA of the elbow, utilizing the 2011 OCEBM levels of evidence. Design. A literature synthesis. Results. Twenty-six articles satisfied the inclusion and exclusion criteria; 25 of the studies were at level IV evidence, and 1 at level III. All three surgical techniques led to improvement in pain, ROM, and functional recovery in the short- and medium-term follow-up. Long-term follow-up results, available only for open joint debridement, showed recurrence of osteoarthritic signs on X-ray with minimal loss of motion. Recently, there seems to be an increased focus on arthroscopic debridement. Conclusion. The quality of research addressing surgical interventions is very low, including total elbow arthroplasty (TEA). However, the evidence concurs that open and arthroscopic joint debridement can improve function in patients with moderate-to-severe OA of the elbow. TEA is reserved for treating severe joint destruction, mostly for elderly individuals with low physical demands when other intervention options have failed.