Elbow arthroscopy in stiff elbow

Purpose

The purpose of this study was to evaluate and review the functional outcomes after arthroscopic surgery in post-traumatic and degenerative elbow contractures.

Methods

Between 2004 and 2008, 243 patients with post-traumatic or degenerative elbow stiffness were treated with arthroscopic surgery. A total of 212 patients were reviewed at an average of 58 months follow-up (SD ± 17.3). The patients were divided into two groups: group A with post-traumatic stiffness, and group B with degenerative stiffness. Arthroscopic procedures performed included: synovectomy, debridement of osteophytes, removal of loose bodies, anterior and posterior capsulectomy, radial head excision. Ulnar nerve neurolysis was usually performed. The following data were recorded and analysed: sex, age, paraesthesia, previous surgical treatment and complications. Patient outcome was assessed pre- and post-operatively by a visual analogue scale and by the Mayo Elbow Performance Index (MEPI), which assesses pain, ROM, stability and function.

Results

The total average ROM improved by 33° in group A and 20° in Group B. The MEPI improved from 60 to 81 in group A, and from 65 to 91 in group B.

Conclusions

Arthroscopic surgery in post-traumatic and degenerative elbow contractures can be considered a safe, useful, with a long learning curve procedure that offers important improvement of the ROM decreasing surgical morbidity.

Level of evidence

IV.