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Arthroscopic release for the severely stiff elbow

  • K. TemporinEmail author
  • K. Shimada
  • K. Oura
  • H. Owaki
Original Article

Abstract

Background

Arthroscopic release for the stiff elbow has been widely used, but there are no reports limited to severe stiffness. The purpose of this study was to investigate the outcomes of severe cases.

Materials and methods

Ten patients with 10 severely stiff elbows defined by a limited arc of ≤ 60° underwent this arthroscopic release. Causes of stiffness were post-traumatic stiffness (one patient), osteoarthritis (three patients), and rheumatoid arthritis (six patients). Using arthroscopy, the capsule contracture and the intra-articular fibrosis were removed and the impinging osteophyte and part of the radial head were resected. For four patients with preoperative ulnar nerve symptoms or contracture of the posterior oblique ligament of the medial collateral ligament, mini-open ulnar nerve neurolysis and release of the posterior oblique ligament were performed. Patients were followed up for an average of 24 months.

Results

Arthroscopic release could be performed without any intraoperative complications. Range of motion for the elbow significantly improved from 95° of flexion and − 55° of extension to 109° of flexion and − 32° of extension. The Mayo Elbow Performance Score also improved from 56 points to 80 points. Two patients underwent a second arthroscopic surgery and gained further arc of motion. One patient showed osteophyte reformation and needed revision open surgery 1 year after the initial surgery.

Conclusions

Arthroscopic release for the severely stiff elbow could improve range of motion. Careful attention should be given during surgery to avoid complications such as intramuscular bleeding or nerve damage.

Keywords

Elbow Severe stiffness Arthroscopy Release Case series 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the institutional review board and performed in accordance with 1964 Helsinki Declaration.

Informed consent

Each patient gave informed consent for participation.

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Copyright information

© Istituto Ortopedico Rizzoli 2019

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryJapan Community Healthcare Organization Osaka HospitalFukushima-kuJapan
  2. 2.Department of Emergency/Sports MedicineJapan Community Healthcare Organization Osaka HospitalFukushima-kuJapan
  3. 3.Department of RheumatologyJapan Community Healthcare Organization Osaka HospitalFukushima-kuJapan

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