Arthroscopic arthrolysis for posttraumatic elbow stiffness

Background: Loss of motion of the elbow joint is a common finding after elbow trauma. Restoration of motion of the posttraumatic stiff elbow can be a difficult, time-consuming, and costly challenge. Arthroscopic capsular release of stiff elbows has recently been introduced as a safe but technically demanding technique. The outcome in 27 patients treated by arthroscopic capsular release was assessed. Materials and methods: We evaluated 27 patients (17 women) who were an average age of 42 years (range, 14-65) at 3, 12, and 24 months after arthroscopic capsular release of a posttraumatic stiff elbow. Range of motion (ROM) and Elbow Function Assessment (EFA) were measured. Results: Before the arthroscopic procedure, the mean flexion was 123 degrees (SD 8 degrees), extension was 24 degrees (SD 9 degrees), and total ROM was 99 degrees (SD 11 degrees), and after surgery, flexion improved significantly to 133 degrees (SD 5 degrees), extension to 7 degrees (SD 6 degrees), and total ROM to 125 degrees (SD 10 degrees). The mean (SD) EFA showed improvement from 69 (SD 4) preoperatively to 91 (SD 4) postoperatively. The postoperative outcomes at 3, 12 and 24 months were similar. One postoperative superficial infection of the lateral portal occurred and was successfully treated with oral antibiotics. No vascular or neurologic complications were noted. Discussion: Historical data underscore the fact that arthroscopic release of posttraumatic elbow contracture is technically demanding but can effective improve the elbow arc of motion. Conclusion: Arthroscopic capsular release of the elbow is a safe and reliable treatment for patients with a posttraumatic elbow contracture. Level of evidence: Level IV, Case Series, Treatment Study. (C) 2011 Journal of Shoulder and Elbow Surgery Board of Trustees.