Arthroscopic release of resistant stiff elbow

Abstract

IntroductionElbow stiffness represents a difficult therapeutic challenge. The complaints are classically characterized by pain and loss of motion. Treatment options include nonoperative and operative techniques, all attempting to provide pain relief and restoration of function. If nonsurgical treatment fails, operative intervention is indicated. Treatment of the stiff elbow by means of arthroscopic capsular release is a relatively new and effective procedure; however, the surgery is technically demanding. The aim of this study was to evaluate the clinical outcomes of arthroscopic release of resistant stiff elbow.Patients and methodsTwenty patients with elbow stiffness were treated by means of arthroscopic capsular release through anterolateral and anteromedial elbow portals, using arthroscopic ablation device and shaver. Posterior and posterolateral portals were used to remove loose bodies, debris, or scar tissue in the olecranon fossa. The patients were prospectively followed up clinically for a mean of 24 months (range = 16-30 months). The clinical assessment was performed with the Mayo Elbow Performance score.ResultsEighteen patients were satisfied with the outcome. There was a significant improvement in the range of motion and reduction of pain. The mean Mayo Elbow Performance score was significantly improved from a mean of 45.3 preoperatively to 95.3 postoperatively.ConclusionThe early results of arthroscopic release of resistant stiff elbow are encouraging and provide symptomatic improvement in most patients. It shortens the time to achieve a good function.