Abstract

Purpose: The purpose of this study is to evaluate the outcomes and the complication rates of arthroscopic arthrolysis of the stiff elbow. The hypothesis presented is that arthroscopic arthrolysis is a safe and effective technique that can return patients to high range of motion and function in their elbows and a great degree of patient satisfaction, whether the stiffness is of osteoarthritic or post-traumatic origin.

Methods: This is a retrospective study. We have made a review on 38 patients with stiff elbow due to degenerative or post-traumatic reasons, and who were treated by arthroscopic arthrolysis between 2013 and 2016, with a mean follow-up of 25 months (38-15). Elbow stiffness was classified following the Morrey scale and the Mayo Elbow Performance Index (MEPI) functional scale was used to evaluate pain, mobility, stability and elbow function pre- and post-operatively. The arthroscopic procedures performed on each patient are described, including synovectomy, debridement of fibrous tissue, anterior and/or posterior capsulotomy, resection of osteophytes in the anterior and posterior part of the elbow, extirpation of loose bodies and open release of the ulnar nerve.

Results: Mobility increased 40.13; 16.71 degrees in flexion and 23'42º in extension. The MEPI scale improved from 65 (+/- 15) to 93 (+/- 20). 35 patients achieved a functional range of motion of at least 100º (130º of flexion and -30º of extension). The patients of group 1 (degenerative origin of elbow stiffness) improved 35º and those of group 2 (posttraumatic origin of elbow stiffness) improved 45'83º. All of these results being statistically significant (p < 0´05) We had 1 case of superficial infection in a portal, which solved with antibiotic treatment; 3 cases of ulnar nerve neuritis, with spontaneous recovery before 6 months; and 2 cases in which a reoperation was necessary due to recurrence of stiffness: one with good results (from -40º of preoperative extension and 100º of flexion to -30º of postoperative extension and 120º of flexion) and the other continues with good mobility but pain that doesn´t allow him to do his job, he has requested for work disability and does not want a new surgical intervention.

Conclusion: Arthroscopic arthrolysis of the elbow is a safe and effective technique which enables good functional results to be obtained in the treatment of degenerative or post-traumatic stiff elbow, even in severe cases, with a low complication rate.

  In the patients of this study, the complete mobility of the elbow could not be restored with this technique; we must inform our patients of this risk Level of Evidence: IV

Keywords: Elbow Arthroscopy; Elbow Stiffness; Elbow Arthrolysis

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Citation

Citation: Pablo Cañete San Pastorab. "Can we Obtain Good Results in the Treatment of Elbow Stiffness of Degenerative or Posttraumatic Origin".Acta Scientific Orthopaedics 3.2 (2020): 41-53.

Copyright

Copyright: © 2020 Pablo Cañete San Pastorab. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.