Comparison of clinical outcomes between the olecranon osteotomy approach and the Bryan-Morrey approach for total elbow arthroplasty.

BACKGROUND: This study aims to investigate the clinical efficacy of the olecranon osteotomy approach and the Bryan-Morrey approach in total elbow arthroplasty (TEA).

METHODS: In this retrospective study, 49 patients with elbow disease were treated with TEA. A total of 22 patients with TEA by olecranon osteotomy approach were designated as group A, and 27 patients with TEA by Bryan-Morrey approach were designated as group B. There were 22 males and 27 females; ages 32 to 82 years with a mean age of 62 years. There were 44 cases of unilateral elbow joint, including 27 cases on the left side and 17 cases on the right side, and five cases of the bilateral elbow joint. There were six cases of osteoarthritis (7 sides), 18 cases of rheumatoid arthritis (22 sides), 14 cases of traumatic arthritis (14 sides), 7 cases of distal humeral fractures (7 sides), and 4 cases of elbow tuberculosis (4 sides). For each group, we recorded the operative time, intraoperative bleeding, elbow flexion, extension, pronation, supination, postoperative complication rates, and Mayo Elbow Performance Score (MEPS) after surgery.

RESULTS: Operative time and intraoperative bleeding were less in Group A than in group B. [53-120 min [70 (62.5,78) min] vs 64-105 min [77 (73,87) min], 10-200 ml [50 (20,90) ml] vs 5-250 ml [100 (50,150) ml], P < 0.028]. The elbow flexion, pronation activity, and MEPS scores were higher in Group A than in Group B, [(121±12) ° vs (112±10)°, 85 (85,85)° vs 80 (77,85)°, (94 ± 3) points vs (91 ± 4) points, P<0.036], while elbow extension and supination activity and complication rates were not statistically significant in either group.

CONCLUSION: Compared to Bryan-Morrey approach, the olecranon osteotomy approach to TEA provides adequate visualization, saves operative time and reduces bleeding, provides better flexion activity, effectively improves elbow function, and achieves satisfactory clinical outcomes.