Arthroscopic Treatment of Elbow Stiffness

Abstract

To present the arthroscopic surgical technique and the evaluation of the results from this technique for treating elbow stiffness. Methods: Between April 2007 and January 2010, ten elbows of ten patients with elbow stiffness underwent arthroscopic treatment to release the range of motion. The minimum follow-up was 11 months, with an average of 27 months. All the patients were male and their average age was 32.8 years (ranging from 22 to 48 years). After the arthroscopic treatment, they were followed up weekly in the first month and every three months thereafter. The clinical evaluation was made using the criteria of the University of California at Los Angeles (UCLA). Results: All the patients were satisfied with the results from the arthroscopic treatment. The average UCLA score was 33.8 points. Conclusion: Arthroscopic treatment for elbow stiffness is a minimally invasive surgical technique that was shown to be efficient for treating this complication.

Elbow arthroscopy - Indications and technique

“…osteoarthritis, inflammatory arthritis, loose bodies, heterotopic ossifications and synovitis). 5,14,15 Stiffness of the elbow can be a very debilitating condition, whereby the patient is no longer able to reach his own mouth or face, or when the elbow cannot be sufficiently extended for the completion of daily tasks such as riding a bike or reaching for objects. The inability to pronate can be a hindrance to activities of daily living such as using a keyboard, writing and other similar tasks, although some people can compensate for a mild protonation impairment by abducting and internally rotating their shoulder.…”

“…The general agreement that an indication for surgery arises when there is an extension deficit of more than 30 or the inability to flex the elbow to at least 120 , or smaller deficiencies impairing a patient's lifestyle. 14,15 However, this should not be used as a strict guideline: a thorough individual assessment of the presenting problems and the potential benefits of intervention should be done. 14,15 When addressing a symptomatic stiff elbow joint, most can be treated arthroscopically by releasing the capsule, removing osteophytes when present and possibly remodeling parts of the joint that contribute to impingement in end range of motion.…”

“…14,15 However, this should not be used as a strict guideline: a thorough individual assessment of the presenting problems and the potential benefits of intervention should be done. 14,15 When addressing a symptomatic stiff elbow joint, most can be treated arthroscopically by releasing the capsule, removing osteophytes when present and possibly remodeling parts of the joint that contribute to impingement in end range of motion. 5,14 Although some authors have shown success with arthroscopic release of complex stiff elbows, 5 a low threshold for an open arthrolysis is advised when dealing with extensive heterotopic ossifications, gross (posttraumatic) anatomic deformations or conditions where the ulnar nerve needs to be released.…”

“…14,15 When addressing a symptomatic stiff elbow joint, most can be treated arthroscopically by releasing the capsule, removing osteophytes when present and possibly remodeling parts of the joint that contribute to impingement in end range of motion. 5,14 Although some authors have shown success with arthroscopic release of complex stiff elbows, 5 a low threshold for an open arthrolysis is advised when dealing with extensive heterotopic ossifications, gross (posttraumatic) anatomic deformations or conditions where the ulnar nerve needs to be released. The latter specifically applies when treating a longstanding severe impairment where flexion is limited to 100 or less.…”