Skip to main content
SpringerLink
Log in

Outcomes of arthroscopic arthrolysis for the post-traumatic elbow stiffness

  • Elbow
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Post-traumatic contracture is a common complication after elbow trauma. If conservative therapy fails to restore adequate elbow motion, surgical release is recommended. Increase in arthroscopy knowledge and skills, as well as technological advances in the passed decade of years, has made arthroscopic arthrolysis a safe and reliable treatment for patients with a post-traumatic elbow contracture. The aim of this study was to report on the clinical outcome and improvement of ROM in post-traumatic stiff elbow treated by arthroscopic arthrolysis.

Methods

Between 2008 and 2012, 34 consecutive patients with post-traumatic stiffness were treated with arthroscopic arthrolysis. Active and passive elbow movement is encouraged the day after operation with the effective pain management. Mayo Elbow Performance Index (MEPI) and visual analogue scale were measured.

Results

At the final follow-up, the average arc of elbow motion increased from 48.6 ± 19.3 pre-operatively to 114.5 ± 25.7, with a mean improvement of 65.9°. The MEPI score improved from 68.2 ± 16.4 pre-operatively to 92.4 ± 21.6, with a mean improvement of 24.2 (p < 0.001). Results were good to excellent in 29 patients.

Conclusion

Injuries are the most common cause of elbow stiffness requiring surgical release. The procedure of arthroscopic arthrolysis is a good option for the treatment of post-traumatic elbow stiffness as it restores normal elbow function. Early passive/active post-operative rehabilitation is very important.

Level of evidence

Case series, treatment study, Level IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Aldridge JM III, Atkins TA, Gunneson EE, Urbaniak JR (2004) Anterior release of the elbow for extension loss. J Bone Joint Surg Am 86-A(9):1955–1960

    PubMed  Google Scholar 

  2. Ball CM, Meunier M, Galatz LM, Calfee R, Yamaguchi K (2002) Arthroscopic treatment of post-traumatic elbow contracture. J Shoulder Elbow Surg 11(6):624–629

    Article  PubMed  Google Scholar 

  3. Breen TF, Gelberman RH, Ackerman GN (1988) Elbow flexion contractures: treatment by anterior release and continuous passive motion. J Hand Surg Br 13(3):286–287

    Article  CAS  PubMed  Google Scholar 

  4. Cefo I, Eygendaal D (2011) Arthroscopic arthrolysis for posttraumatic elbow stiffness. J Shoulder Elbow Surg 20(3):434–439

    Article  PubMed  Google Scholar 

  5. Cikes A, Jolles BM, Farron A (2006) Open elbow arthrolysis for posttraumatic elbow stiffness. J Orthop Trauma 20(6):405–409

    Article  PubMed  Google Scholar 

  6. Ehsan A, Huang JI, Lyons M, Hanel DP (2012) Surgical management of posttraumatic elbow arthrofibrosis. J Trauma Acute Care Surg 72(5):1399–1403

    PubMed  Google Scholar 

  7. Gallay SH, Richards RR, O’Driscoll SW (1993) Intraarticular capacity and compliance of stiff and normal elbows. Arthroscopy 9(1):9–13

    Article  CAS  PubMed  Google Scholar 

  8. Gosling T, Blauth M, Lange T, Richter M, Bastian L, Krettek C (2004) Outcome assessment after arthrolysis of the elbow. Arch Orthop Trauma Surg 124(4):232–236

    Article  CAS  PubMed  Google Scholar 

  9. Gundlach U, Eygendaal D (2008) Surgical treatment of posttraumatic stiffness of the elbow: 2-year outcome in 21 patients after a column procedure. Acta Orthop 79(1):74–77

    Article  PubMed  Google Scholar 

  10. Higgs ZC, Danks BA, Sibinski M, Rymaszewski LA (2012) Outcomes of open arthrolysis of the elbow without post-operative passive stretching. J Bone Joint Surg Br 94(3):348–352

    Article  CAS  PubMed  Google Scholar 

  11. Husband JB, Hastings H II (1990) The lateral approach for operative release of post-traumatic contracture of the elbow. J Bone Joint Surg Am 72(9):1353–1358

    CAS  PubMed  Google Scholar 

  12. Kodde IF, van Rijn J, van den Bekerom MP, Eygendaal D (2013) Surgical treatment of post-traumatic elbow stiffness: a systematic review. J Shoulder Elbow Surg 22(4):574–580

    Article  PubMed  Google Scholar 

  13. Lapner PC, Leith JM, Regan WD (2005) Arthroscopic debridement of the elbow for arthrofibrosis resulting from nondisplaced fracture of the radial head. Arthroscopy 21(12):1492

    Article  PubMed  Google Scholar 

  14. Lindenhovius AL, Jupiter JB (2007) The posttraumatic stiff elbow: a review of the literature. J Hand Surg Am 32(10):1605–1623

    Article  PubMed  Google Scholar 

  15. Morrey BF (1990) Post-traumatic contracture of the elbow. Operative treatment, including distraction arthroplasty. J Bone Joint Surg Am 72(4):601–618

    CAS  PubMed  Google Scholar 

  16. Morrey BF (2005) The posttraumatic stiff elbow. Clin Orthop Relat Res 431:26–35

    PubMed  Google Scholar 

  17. Morrey BF, Adams RA (1992) Semiconstrained arthroplasty for the treatment of rheumatoid arthritis of the elbow. J Bone Joint Surg Am 74(4):479–490

    CAS  PubMed  Google Scholar 

  18. Morrey BF, Askew LJ, Chao EY (1981) A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am 63(6):872–877

    CAS  PubMed  Google Scholar 

  19. Myden C, Hildebrand K (2011) Elbow joint contracture after traumatic injury. J Shoulder Elbow Surg 20(1):39–44

    Article  PubMed  Google Scholar 

  20. Nandi S, Maschke S, Evans PJ, Lawton JN (2009) The stiff elbow. Hand (NY) 4(4):368–379

    Article  Google Scholar 

  21. Olivier LC, Assenmacher S, Setareh E, Schmit-Neuerburg KP (2000) Grading of functional results of elbow joint arthrolysis after fracture treatment. Arch Orthop Trauma Surg 120(10):562–569

    Article  CAS  PubMed  Google Scholar 

  22. Park MJ, Kim HG, Lee JY (2004) Surgical treatment of post-traumatic stiffness of the elbow. J Bone Joint Surg Br 86(8):1158–1162

    Article  CAS  PubMed  Google Scholar 

  23. Pederzini LA, Nicoletta F, Tosi M, Prandini M, Tripoli E, Cossio A (2014) Elbow arthroscopy in stiff elbow. Knee Surg Sports Traumatol Arthrosc 22(2):467–473

    Article  PubMed  Google Scholar 

  24. Rex C, Suresh Kumar PM, Srimannarayana A, Chugh S, Ravichandran M, Harish DN (2008) Analysis of results of surgical treatment of posttraumatic stiff elbow. Indian J Orthop 42(2):192–200

    Article  PubMed Central  PubMed  Google Scholar 

  25. Ruch DS, Shen J, Chloros GD, Krings E, Papadonikolakis A (2008) Release of the medial collateral ligament to improve flexion in post-traumatic elbow stiffness. J Bone Joint Surg Br 90(5):614–618

    Article  CAS  PubMed  Google Scholar 

  26. Rupp S, Tempelhof S (1995) Arthroscopic surgery of the elbow. Therapeutic benefits and hazards. Clin Orthop Relat Res 313:140–145

    PubMed  Google Scholar 

  27. Sahajpal D, Choi T, Wright TW (2009) Arthroscopic release of the stiff elbow. J Hand Surg Am 34(3):540–544

    Article  PubMed  Google Scholar 

  28. Salter RB, Hamilton HW, Wedge JH, Tile M, Torode IP, O’Driscoll SW, Murnaghan JJ, Saringer JH (1984) Clinical application of basic research on continuous passive motion for disorders and injuries of synovial joints: a preliminary report of a feasibility study. J Orthop Res 1(3):325–342

    Article  CAS  PubMed  Google Scholar 

  29. Soucie JM, Wang C, Forsyth A, Funk S, Denny M, Roach KE, Boone D (2011) Range of motion measurements: reference values and a database for comparison studies. Haemophilia 17(3):500–507

    Article  CAS  PubMed  Google Scholar 

  30. Swaroop A, Avasthi S, Yadav M, Kumar S, Bharti A, Sengar G (2009) Assessment of results of open arthrolysis in post traumatic stiff elbows. Internet J Orthop Surg 11(2):p1

  31. Stans AA, Maritz NG, O’Driscoll SW, Morrey BF (2002) Operative treatment of elbow contracture in patients twenty-one years of age or younger. J Bone Joint Surg Am 84-A(3):382–387

    PubMed  Google Scholar 

  32. Wilson PD (1944) Capsulectomy for the relief of flexion contractures of the elbow following fracture. Clin Orthop Relat Res 2000:3–8

    Google Scholar 

Download references

Acknowledgments

Grant sponsor: National Natural Science Foundation of China. Grant Number: 81201393.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China

    Xinghuo Wu, Hong Wang, Chunqing Meng, Shuhua Yang, Deyu Duan, Weihua Xu, Xianzhe Liu, Ming Tang & Jianning Zhao

Authors
  1. Xinghuo Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hong Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chunqing Meng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shuhua Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Deyu Duan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Weihua Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xianzhe Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ming Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jianning Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hong Wang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wu, X., Wang, H., Meng, C. et al. Outcomes of arthroscopic arthrolysis for the post-traumatic elbow stiffness. Knee Surg Sports Traumatol Arthrosc 23, 2715–2720 (2015). https://doi.org/10.1007/s00167-014-3032-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-014-3032-3

Keywords

Search

Navigation