Recovery from open osteocapsular débridement for primary elbow osteoarthritis is rapid and does not depend on preoperative motion
Background and Hypothesis: Osteocapsular débridement is a surgical treatment for functionally limiting primary elbow osteoarthritis (PEOA). We hypothesized that postoperative improvement in range of motion (ROM) following elbow osteocapsular débridement could be grouped into predictable patterns. We...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | JSES International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638322001487 |
| _version_ | 1798046352202006528 |
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| author | Farhan Ahmad, MD Sal Ayala, BS Nabil Mehta, MD Mark S. Cohen, MD Xavier C. Simcock, MD Robert W. Wysocki, MD |
| author_facet | Farhan Ahmad, MD Sal Ayala, BS Nabil Mehta, MD Mark S. Cohen, MD Xavier C. Simcock, MD Robert W. Wysocki, MD |
| author_sort | Farhan Ahmad, MD |
| collection | DOAJ |
| description | Background and Hypothesis: Osteocapsular débridement is a surgical treatment for functionally limiting primary elbow osteoarthritis (PEOA). We hypothesized that postoperative improvement in range of motion (ROM) following elbow osteocapsular débridement could be grouped into predictable patterns. We also hypothesized that significant improvements in ROM frequently take place for up to 6 months after surgery. Methods: A retrospective chart review of patients who underwent open elbow débridement for PEOA was performed. Demographic information and surgical approach were recorded. ROM data were also collected at preoperative, intraoperative, and postoperative intervals of 2 weeks, 6 weeks, 3 months, and 6 months. Growth mixture modeling and latent class growth analysis were performed to identify groups of motion recovery trajectories, while Student’s t-tests were performed to compare ROM data between intervals. Results: Our study included 76 patients who underwent open elbow débridement (9 with a lateral approach, 55 medial, and 12 both) for PEOA. The mean preoperative arc of motion was 95° ± 22°. This improved to a mean final motion arc of 127° ± 11 at final follow-up, which was 92% of the mean intraoperative arc. The mean time to achieve final motion was 3 months, with 79% of patients achieving their final ROM arc by this point. Patients achieved an average of 85% of their final arc of motion by the 2-week postoperative visit (92% of final flexion and 61% of final extension). Growth mixture modeling and latent class growth analysis did not identify any statistically significant groupings for postoperative ROM progression trajectories. Arc of motion preoperatively, intraoperatively, and at 2 weeks postoperatively did not correlate with the final arc of motion. There were no characteristics or thresholds of motion which conferred a higher likelihood of achieving a better result postoperatively. Conclusions: ROM recovery after osteocapsular débridement for PEOA is not dependent on preoperative, intraoperative, or 2-week postoperative arcs of motion. Most of the ROM recovery occurs in the early postoperative period, with flexion restored preferentially faster than extension. The final arc of motion can be expected by 3 months postoperatively. This knowledge has potential benefit in affecting patients’ personal time commitment to rehabilitation and the overall cost for therapy and splinting beyond the 3-month time point. |
| first_indexed | 2024-04-11T23:36:22Z |
| format | Article |
| id | doaj.art-ea023de8eb6745788801aa9feadc1d53 |
| institution | Directory Open Access Journal |
| issn | 2666-6383 |
| language | English |
| last_indexed | 2024-04-11T23:36:22Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj.art-ea023de8eb6745788801aa9feadc1d532022-12-22T03:56:57ZengElsevierJSES International2666-63832022-11-016610481053Recovery from open osteocapsular débridement for primary elbow osteoarthritis is rapid and does not depend on preoperative motionFarhan Ahmad, MD0Sal Ayala, BS1Nabil Mehta, MD2Mark S. Cohen, MD3Xavier C. Simcock, MD4Robert W. Wysocki, MD5Rush University Medical Center, Chicago, IL, USA; Corresponding author: Farhan Ahmad, MD, Rush University Medical Center, Department of Orthopaedic Surgery, 1611 W. Harrison St., Chicago, IL 60612, USA.University of Illinois College of Medicine, Chicago, IL, USARush University Medical Center, Chicago, IL, USARush University Medical Center, Chicago, IL, USARush University Medical Center, Chicago, IL, USARush University Medical Center, Chicago, IL, USABackground and Hypothesis: Osteocapsular débridement is a surgical treatment for functionally limiting primary elbow osteoarthritis (PEOA). We hypothesized that postoperative improvement in range of motion (ROM) following elbow osteocapsular débridement could be grouped into predictable patterns. We also hypothesized that significant improvements in ROM frequently take place for up to 6 months after surgery. Methods: A retrospective chart review of patients who underwent open elbow débridement for PEOA was performed. Demographic information and surgical approach were recorded. ROM data were also collected at preoperative, intraoperative, and postoperative intervals of 2 weeks, 6 weeks, 3 months, and 6 months. Growth mixture modeling and latent class growth analysis were performed to identify groups of motion recovery trajectories, while Student’s t-tests were performed to compare ROM data between intervals. Results: Our study included 76 patients who underwent open elbow débridement (9 with a lateral approach, 55 medial, and 12 both) for PEOA. The mean preoperative arc of motion was 95° ± 22°. This improved to a mean final motion arc of 127° ± 11 at final follow-up, which was 92% of the mean intraoperative arc. The mean time to achieve final motion was 3 months, with 79% of patients achieving their final ROM arc by this point. Patients achieved an average of 85% of their final arc of motion by the 2-week postoperative visit (92% of final flexion and 61% of final extension). Growth mixture modeling and latent class growth analysis did not identify any statistically significant groupings for postoperative ROM progression trajectories. Arc of motion preoperatively, intraoperatively, and at 2 weeks postoperatively did not correlate with the final arc of motion. There were no characteristics or thresholds of motion which conferred a higher likelihood of achieving a better result postoperatively. Conclusions: ROM recovery after osteocapsular débridement for PEOA is not dependent on preoperative, intraoperative, or 2-week postoperative arcs of motion. Most of the ROM recovery occurs in the early postoperative period, with flexion restored preferentially faster than extension. The final arc of motion can be expected by 3 months postoperatively. This knowledge has potential benefit in affecting patients’ personal time commitment to rehabilitation and the overall cost for therapy and splinting beyond the 3-month time point.http://www.sciencedirect.com/science/article/pii/S2666638322001487ElbowOsteocapsular débridementPrimary osteoarthritisMotion recoveryOpen release |
| spellingShingle | Farhan Ahmad, MD Sal Ayala, BS Nabil Mehta, MD Mark S. Cohen, MD Xavier C. Simcock, MD Robert W. Wysocki, MD Recovery from open osteocapsular débridement for primary elbow osteoarthritis is rapid and does not depend on preoperative motion JSES International Elbow Osteocapsular débridement Primary osteoarthritis Motion recovery Open release |
| title | Recovery from open osteocapsular débridement for primary elbow osteoarthritis is rapid and does not depend on preoperative motion |
| title_full | Recovery from open osteocapsular débridement for primary elbow osteoarthritis is rapid and does not depend on preoperative motion |
| title_fullStr | Recovery from open osteocapsular débridement for primary elbow osteoarthritis is rapid and does not depend on preoperative motion |
| title_full_unstemmed | Recovery from open osteocapsular débridement for primary elbow osteoarthritis is rapid and does not depend on preoperative motion |
| title_short | Recovery from open osteocapsular débridement for primary elbow osteoarthritis is rapid and does not depend on preoperative motion |
| title_sort | recovery from open osteocapsular debridement for primary elbow osteoarthritis is rapid and does not depend on preoperative motion |
| topic | Elbow Osteocapsular débridement Primary osteoarthritis Motion recovery Open release |
| url | http://www.sciencedirect.com/science/article/pii/S2666638322001487 |
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