Randomized trial for the treatment of post-traumatic elbow stiffness: surgical release vs. rehabilitation

Guglielmetti, Cesar Luiz Betoni; Gracitelli, Mauro Emílio Conforto; Assunção, Jorge Henrique; Andrade-Silva, Fernando Brandão; Pessa, Mariana Miranda Nicolosi; Luzo, Maria Cândida Miranda; Neto, Arnaldo Amado Ferreira; Malavolta, Eduardo Angeli

doi:10.1016/j.jse.2020.03.023

Cited by 10 publications

(6 citation statements)

References 23 publications

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“…Joint stiffness is a frequent complication of elbow trauma, and about 10 to 15% of patients will need some type of surgery during the treatment, once a 50º reduction in elbow mobility can result in up to 80% of functional loss. 10 The most common cause of elbow stiffness is the contraction of soft tissues after the initial injury, which worsens with the use of prolonged immobilization. 11 The elbow capsule becomes thick and there is an increase in the amount of type I, III and V collagen fibers, proteoglycans and MMP-1 and 13, as well as the formation of myofibroblasts in a posttraumatic elbow stiffness.…”

Section: Discussionmentioning

confidence: 99%

The Polymorphism of Metalloproteinases 1 and 13 and Posttraumatic Elbow Stiffness

et al. 2022

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Introduction To evaluate the relationship between the genetic polymorphism of matrix metalloproteinases 1 and 13 and posttraumatic elbow stiffness, as well as the association of other risk factors with this condition. Materials and methods We evaluated 20 patients with posttraumatic elbow stiffness and 12 controls with traumatic elbow disorders without contracture. Deoxyribonucleic acid (DNA) was obtained from buccal mucosa epithelial cells of the volunteers. The MMP-1 and MMP-13 genotypes were determined using PCR-restriction fragment length polymorphism assays. Results We did not find any significant differences in the frequency of genotypes and alleles between the test and control groups for the polymorphism of metalloproteinases 1 and 13. We observed that genotypes 1G/2G and 2G/2G of MMP-1 were present in 65% (13/20) of patients with articular stiffness and 50% (6/12) of controls (p = 0.599). Genotypes A/A and A/G of MMP-13 were obtained in 95% (19/20) of patients and 91.6% (11/12) of controls (p = 0.491). Among the prognostic factors for elbow stiffness, only immobilization time correlated positively. The mean immobilization time for cases and controls were 16 ± 10 days and 7 ± 7 days, respectively (p = 0.017). Conclusion The genetic polymorphism of MMP-1 at position -1607 and MMP-13 at position -77 was not associated with post-traumatic elbow stiffness. Level of Evidence III; Prognosis Study; Case-Control Study.

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Section: Discussionmentioning

confidence: 99%

The Polymorphism of Metalloproteinases 1 and 13 and Posttraumatic Elbow Stiffness

et al. 2022

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“…In a randomized controlled trial, Guglielmetti et al showed that patients undergoing surgical elbow release for post-traumatic OA and treated with a postoperative rehabilitation protocol resulted in a greater final arc of motion than those treated with rehabilitation alone. 8 Despite these findings, there is no consensus on postoperative rehabilitation protocol for elbow release. Static and dynamic splinting is beneficial for up to 12 months in patients treated nonoperatively for post-traumatic OA, indicating that the capsule can stretch over time.…”

Section: Discussionmentioning

confidence: 99%

Range of motion progression patterns following open release for post-traumatic elbow stiffness

Ahmad¹,

Torres-Gonzales²,

Mehta³

et al. 2022

JSES International

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“…Elbow stiffness is common after an injury. A recent randomized trial of 30 patients with posttraumatic elbow stiffness for >6 months who also underwent failed conventional physical therapy for 4 months was performed 7 . One group underwent a rehabilitation protocol employing orthoses (static progressive for extension and dynamic for flexion) and continuous passive motion, and the other group underwent surgical release via a posterior approach without triceps detachment, followed by a rehabilitation protocol similar to that of the conservative group.…”

Section: Elbowmentioning

confidence: 99%

What’s New in Orthopaedic Trauma

Nguyen

Vallier

2021

Journal of Bone and Joint Surgery

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Randomized trial for the treatment of post-traumatic elbow stiffness: surgical release vs. rehabilitation

Cited by 10 publications

References 23 publications

The Polymorphism of Metalloproteinases 1 and 13 and Posttraumatic Elbow Stiffness

The Polymorphism of Metalloproteinases 1 and 13 and Posttraumatic Elbow Stiffness

Range of motion progression patterns following open release for post-traumatic elbow stiffness

What’s New in Orthopaedic Trauma

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