The Outerbridge and Kashiwagi (OK) Procedure

The OK procedure is used to remove loose bone from inside the elbow or to improve pain and movement for a stiff elbow. 

A short incision is made to the back of the elbow and the triceps muscle is split lengthways. At this stage, any loose bone can be removed directly from the back of the joint.  Any spurs on the bone caused by any arthritis can also be removed. This should enable the elbow to straighten. 

A small hole is then made through a thin plate of bone at the lower end of the arm bone, the humerus, to provide access to the front of the joint.  Through this hole, additional loose bone and spurs can be removed.  The joint is then washed out to remove any small debris and the tricep muscle is repaired.   


Patients will use a sling for one to two weeks for comfort, and will be encouraged to mobilise early with physiotherapy. The procedure is generally successful with high levels of patient satisfaction with improvements in pain and movement.  In more arthritic joints, the movement may improve but the pain may still be present, which may lead to further surgery for example a joint replacement.