Surgical treatment of the stiff elbow can be performed either arthroscopically or via an open approach. There is a paucity of direct prospective comparisons of the techniques in the literature.
The aim of the study is to analyze the clinical short-term results of arthroscopic and open elbow arthrolysis in postoperative and posttraumatic stiff elbows.
The study group consisted of 44 patients divided in two cohorts, one after arthroscopic arthrolysis (33 patients) and the other including patients after open arthrolysis (11 patients). Range of motion (ROM; extension/flexion), pain (numerical rating scale, NRS), as well as the disabilities of the arm, shoulder, and hand (DASH) score were recorded preoperatively and examined in a standardized manner 6 weeks, 3 months, and 6 months after surgery.
In both groups, preoperative elbow movement significantly improved in the follow-up. An increase from 103.3° (±23.4) to 123.5° (±12.5°; p = 0.001) was seen after 6 months for the arthroscopic group, whereas the mean ROM significantly increased from 64.5° (±31.1°) to 100.9° (±25.6°; p = 0.007) following open arthrolysis.
In the arthroscopic group, the DASH score was measured at 37.3 points (±23.4 points) and improved to 16.1 points (±16.5 points) after 6 months, while in the open group it enhanced after 6 months (19.5 points [±17.5 points]) compared to its preoperative value by 38.2 points (±24.1 points). A consistent improvement was found for NRS, which decreased after surgery in both groups (arthroscopic group = −3.1 [±3.0]; open group = −2.0 [±2.9]). Complications did not occur in either group. When comparing delta values of the groups between the preoperative ROM, DASH score, and NRS, no significant differences were observed (p < 0.05).
Good to excellent functional recovery was seen in both cohorts when evaluating for improvement in the DASH score, the gain in elbow motion, and the decrease in pain. No significant differences were found between the procedures regarding pre- and postoperative measurements. The arthroscopic approach has developed to become an effective alternative to treat posttraumatic elbow stiffness.
Cai J, Wang W, Yan H, Sun Y, Chen W, Chen S, Fan C (2015) Complications of open elbow arthrolysis in post-traumatic elbow stiffness: a systematic review. PLoS ONE 10(9):e138547 CrossRef
Cefo I, Eygendaal D (2011) Arthroscopic arthrolysis for posttraumatic elbow stiffness. J Shoulder Elbow Surg 20(3):434–439 CrossRef
Charalambous CP, Morrey BF (2012) Posttraumatic elbow stiffness. J Bone Joint Surg Am 94(15):1428–1437 CrossRef
Hackl M, Lappen S, Burkhart KJ, Leschinger T, Scaal M, Muller LP, Wegmann K (2015) Elbow positioning and joint Insufflation substantially influence median and radial nerve locations. Clin Orthop Relat Res 473(11):3627–3634 CrossRef
Hackl M, Wegmann K, Leschinger T, Borda A, LP M (2016) Prospektive 1‑Jahres-Ergebnisse der arthroskopischen Arthrolyse des Ellenbogens. Obere Extrem 172:177
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 CrossRef
Kwak JM, Kholinne E, Sun Y, Lim S, Koh KH, Jeon IH (2019) Clinical outcome of osteocapsular arthroplasty for primary osteoarthritis of the elbow: comparison of arthroscopic and open procedure. Arthroscopy 35(4):1083–1089 CrossRef
Leschinger T, Muller LP, Hackl M, Wegmann K (2016) Techniken der Arthrolyse am Ellenbogen. Obere Extrem 11:149–158 CrossRef
Lindenhovius AL, Jupiter JB (2007) The posttraumatic stiff elbow: a review of the literature. J Hand Surg Am 32(10):1605–1623 CrossRef
Lubiatowski P, Slezak M, Walecka J, Breborowicz M, Romanowski L (2018) Prospective outcome assessment of arthroscopic arthrolysis for traumatic and degenerative elbow contracture. J Shoulder Elbow Surg 27(9):e269–e278 CrossRef
Rai S, Zhang Q, Tamang N, Jin S, Wang H, Meng C (2019) Arthroscopic arthrolysis of posttraumatic and non-traumatic elbow stiffness offers comparable clinical outcomes. BMC Musculoskelet Disord 20(1):285 CrossRef
Willinger L, Siebenlist S, Lenich A, Liska F, Imhoff AB, Achtnich A (2018) Arthroscopic arthrolysis provides good clinical outcome in post-traumatic and degenerative elbow stiffness. Knee Surg Sports Traumatol Arthrosc 26(1):312–317 CrossRef
Wu X, Wang H, Meng C, Yang S, Duan D, Xu W, Liu X, Tang M, Zhao J (2015) Outcomes of arthroscopic arthrolysis for the post-traumatic elbow stiffness. Knee Surg Sports Traumatol Arthrosc 23(9):2715–2720 CrossRef
- A prospective comparison of short-term results after arthroscopic and open elbow procedures in elbow stiffness
M.D. T. Leschinger
M.D. M. Hackl
M.D. M. Lenz
M.D. V. Rausch
PhD, M.D. L. P. Müller
PhD, M.D. K. Wegmann
- Springer Medizin
Schulter · Ellenbogen
Print ISSN: 1862-6599
Elektronische ISSN: 1862-6602
Neu im Fachgebiet Orthopädie und Unfallchirurgie
Mail Icon II