Arthroscopic Management of Stiff Elbow

Singh, Harpreet; Nam, Ki Young; Moon, Young Lae

doi:10.3928/01477447-20110427-16

Cited by 12 publications

(6 citation statements)

References 23 publications

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“…The improvement in postoperative arc of motion found in this study is similar to the amount of improvement reported by previous investigators, which tends to average around 50°. 1 , 7 , 8 , 10 The significant improvement in pronation and supination after arthroscopic capsular release found in this study has also been reported by other studies. 1 , 2 , 8 , 10 Schreiner et al 8 reported an improvement of 18% in pronation and supination after arthroscopic elbow capsular release, while the mean improvement of 4.4° (5.4%) pronation and 6.1° (7.7%) supination found in this study is lower than this reported value.…”

Section: Discussionsupporting

confidence: 90%

Incidence of Repeat Elbow Capsular Release After Arthroscopic Elbow Capsular Release

Hall,

Paul,

Lencer

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Elbow capsular release can be performed arthroscopically or through an open method to improve range of motion (ROM). However, it is unclear how frequently patients require an open capsular release after unsatisfactory results from an arthroscopic release. Purpose/Hypothesis: The purpose of this study was to determine the percentage of patients who underwent an arthroscopic elbow release for loss of motion who then required a repeat elbow capsular release or other subsequent surgery on the same elbow. It was hypothesized that patients who underwent arthroscopic elbow release would rarely (<5%) require a subsequent elbow release. Study Design: Case series; Level of evidence, 4. Methods: Patients who underwent arthroscopic elbow capsular release from January 1, 2010, to December 31, 2019, were identified by chart review and procedure code. Demographic parameters, pre- and postoperative ROM, and surgical history were collected by chart review. Follow-up data included patient satisfaction and the Timmerman-Andrews (TA) elbow score. Data were compared between patients who did and those who did not require subsequent elbow surgery. Results: Overall, of 140 study patients (116 male, 24 female; mean age, 49.6 years), 18 (12.9%) required subsequent surgery, including 6 capsular releases (4.3%; 1 open and 5 arthroscopic). The most common follow-up procedure was ulnar nerve releases/transpositions (n = 7). Total arc of elbow motion (flexion to extension) improved by a mean of 51.4°. The mean TA score was 76.5 ± 20.4 at a mean of 5.25 years postoperatively. Mean satisfaction score was 77.6 ± 26.3. In this study, 82.4% of patients stated that their symptoms either improved or resolved completely. Patients who required subsequent surgery had a significantly lower preoperative total arc of elbow motion versus those who did not require subsequent surgery ( P = .046). There was no difference between the groups in symptom resolution, satisfaction, ROM, or TA score ( P ≥ .279 for all). Conclusion: After arthroscopic elbow release, <5% of patients required a repeat elbow capsular release, 12.9% required some form of follow-up elbow surgery, and 4.3% had a new injury of the elbow. Overall, patients saw improvement in elbow ROM, but many still had residual symptoms from their underlying disease after arthroscopic elbow capsular release.

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Section: Discussionsupporting

confidence: 90%

Incidence of Repeat Elbow Capsular Release After Arthroscopic Elbow Capsular Release

Hall,

Paul,

Lencer

et al. 2023

Orthopaedic Journal of Sports Medicine

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“…In most of the cases, some form of modalities, such as ultrasonic heat and physiotherapy along with anti-inflammatory medications improves the ROM. But in severe elbow stiffness surgery is generally needed [31].…”

Section: • Stiff Elbowmentioning

confidence: 99%

“…Manipulation under anesthesia after inflating the joint with saline can be done in a controlled manner in less severe contractures. But it is a risky procedure with complications such as muscle tear, fractures, neurovascular, and ligament injury [30,31].…”

Section: • Stiff Elbowmentioning

confidence: 99%

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Elbow Arthroscopy

Sonar¹

2016

Arthroplasty - A Comprehensive Review

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Introduction: Elbow joint is a complex articulation of three bones. It is a hinge joint with three types of motions; flexion-extension, varus-valgus and rotations. With advancement of instrumentations, our knowledge about surgical anatomy and surgical skills, elbow arthroscopy has become an excellent tool to treat a wide range of disorders with minimum risk and complications. Pathologies such as tennis elbow, OCD, fracture radial head, fracture capitulum, stiff elbow, synovitis, loose bodies, etc, are now easily treated with arthroscopic technique. Elbow arthroscopy has its role in the management of ligament injuries and instability. There are three major neurovascular bundles in close proximity of elbow joint, the median nerve on posteromedial aspect, the radial nerve on posterolateral side and the ulnar nerve along with brachial vessels anteriorly. Materials & Methods: Procedure can be performed either under general or regional anesthesia. Usually, in young and cooperative patients, regional anesthesia in the form of interscalene, axillary, or Bier's block can be used. In elderly and non-cooperative patients, general anesthesia with or without regional block for postoperative pain management can be used. We usually prefer the lateral position with the elbow freely hanging on the support. But there are three positions described for elbow arthroscopy, supine position, prone position and lateral decubitus position. Conclusion: Elbow arthroscopy is a minimally invasive procedure and provide good to excellent long term results. We can diagnose and treat concomitant intra-articular

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“…bow 13,14 because a stiff elbow capsule has considerably less capacity and compliance than a capsule in a normal elbow, thereby increasing the potential neurovascular injury in elbow arthroscopy. 15 Advocates of a lateral approach claim some advantages, such as less risk of nerve damage and fewer wound complications.…”

Section: A 1bmentioning

confidence: 99%

Open Release and a Hinged External Fixator for the Treatment of Elbow Stiffness in Young Patients

Ouyang¹,

Wang²,

Li³

et al. 2012

Orthopedics

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Elbow stiffness is a well-recognized complication following elbow trauma, but little information is available regarding the surgical treatment of elbow stiffness in children and adolescents. This article presents the results of open arthrolysis with twin incisions and a hinged external fixator to treat severe elbow contracture in children and adolescents. Twenty-one patients (mean age, 14.9 years; range, 7-19 years) were evaluated. All patients underwent surgery using a hinged external fixator and a combined mediolateral approach to address the elbow contracture. Mayo elbow score and range of motion (ROM) were measured preoperatively and at 3, 12, and 24 months postoperatively. All but 1 patient achieved a functional ROM of 100°. Preoperatively, mean flexion was 70.2° (range, 30°-100°), extension was 42.6° (range, 0°-80°), and total ROM was 28.5° (range, 0° to 80°); postoperatively, mean flexion improved to 122.8° (range, 90°-140°), extension to 10° (range, 0°-30°), and total ROM to 114.5° (range, 60°-140°). The Mayo elbow score improved from a mean of 48 points (range, 35-65 points) to 90 points (range, 75-100 points), and 9 patients had excellent results, 7 had good results, 4 had fair results, and 1 had a poor result. No significant differences existed between postoperative measurements at 3, 12, and 24 months. No pin-tract infections or deep infections occurred, and no vascular or neurological complications were noted. Surgical treatment of elbow stiffness using a hinged external fixator and open arthrolysis is an effective procedure in children and adolescents.

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Arthroscopic Management of Stiff Elbow

Cited by 12 publications

References 23 publications

Incidence of Repeat Elbow Capsular Release After Arthroscopic Elbow Capsular Release

Incidence of Repeat Elbow Capsular Release After Arthroscopic Elbow Capsular Release

Elbow Arthroscopy

Open Release and a Hinged External Fixator for the Treatment of Elbow Stiffness in Young Patients

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