Purpose And Hypothesis: The purpose of this retrospective study was to report on the functional outcome after arthroscopic arthrolysis in patients with post-traumatic or degenerative elbow stiffness. It was hypothesized that this operative procedure leads to improved range of motion (ROM) and improved functional outcome in both groups.
Methods: Patients who underwent arthroscopic arthrolysis of the elbow between 2010 and 2015 were included in this study. Forty-two patients with an average age of 41.0 ± 13.5 years were available for evaluation. The mean follow-up was 28.3 ± 14.9 months. With regard to aetiology of elbow contractures, patients were divided into post-traumatic (group A) and degenerative (group B) cohort. General patients' data, previous surgical treatment and ROM were recorded. At follow-up evaluation, the clinical outcome was assessed by the ROM, visual analogue scale (VAS) for pain assessment and the Elbow Self-Assessment Score (ESAS).
Results: The mean arc of motion of group A (n = 20) increased from preoperatively 74.3° to 120.5° postoperatively (p < 0.001); group B (n = 22) showed an improvement of 104.6° preoperatively to 123.4° after surgery (p = 0.002). Mean improvement was 46.3° ± 27.5° in group A and 16.4° ± 19.4° in group B. Mean post-operative VAS was 0.9 ± 1.5 in group A and 1.3 ± 2.2 in group B. 92.9% of patients achieved a functional arc of elbow motion >100°. The ESAS indicated good to excellent clinical outcome showing 88.8 ± 10.0 points in group A and 84.1 ± 21.4 points in group B. Thirty-six patients (85.7%) returned to their previous work level after surgery.
Conclusions: Arthroscopic arthrolysis is an effective treatment option for patients with restriction in elbow motion reasoned by post-traumatic or degenerative changes. Both groups showed a significant improvement of ROM and comparable outcome scores.
Level Of Evidence: Therapeutic study, Level IV.
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http://dx.doi.org/10.1007/s00167-017-4630-7 | DOI Listing |
J Orthop
June 2025
St. Vinzenz Klinik Pfronten, Pfronten, Germany.
Background: Elbow stiffness poses a significant challenge for surgeons as well as physiotherapists during and after surgery. To date, there is no consensus regarding the subsequent rehabilitation after surgical release of the stiff elbow.
Objective: The aim is to evaluate the most important therapeutic strategies following open or arthroscopic release of the stiff elbow based on a comprehensive literature review, and to develop a consensus for or against specific therapeutic methods with the help of a survey among elbow experts of the D-A-CH Association for Shoulder and Elbow Surgery (DVSE).
Orthop Traumatol Surg Res
November 2024
Service d'Orthopédie 2, CHU Lille, France.
Stiffness following total knee replacement is defined as >15° flexion contracture and/or flexion <75° or, for other authors, arc of motion <70° or 45° or 50°. Alternatively, it could be defined as a range of motion less than the patient needs in order to be able to do what they wish. The first step in management is to determine the causes: preoperative (history of stiffness, patient-related risk factors, etc.
View Article and Find Full Text PDFArthrosc Tech
October 2024
Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy.
Hypertrophic osteoarthritis of the elbow is a challenging condition that can vary from mild to severe, affecting patients' quality of life due to pain and loss of range of motion. A consensus about its treatment does not exist. Open arthrolysis with capsular release, synovectomy, Outerbridge-Kashiwagi fenestration, and removal of loose bodies and osteophytes demonstrated good results.
View Article and Find Full Text PDFRadiol Case Rep
January 2025
Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco.
Pigmented villonodular synovitis is a rare proliferative disorder of the synovial joints, characterized by synovial thickening and hemosiderin deposition. It predominantly affects the knee joint, with bilateral involvement being exceedingly rare. We present a case of diffuse bilateral pigmented villonodular synovitis in a 20-year-old female, initially presenting with left knee pain and swelling, diagnosed via MRI.
View Article and Find Full Text PDFArthrosc Tech
September 2024
Sports Medicine Center, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Arthroscopic capsular release is required in some patients with frozen shoulder (FS). In some cases of recalcitrant FS, arthroscopic capsular release is difficult because of the abnormal narrowing of the joint space. The aim of this article is to introduce an arthroscopic double posterior approach combined with lateral and anterior approaches that is used to complete release of the glenohumeral joint capsule at 360°, subacromial debridement, and long head of biceps tenotomy.
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