Outcomes of Arthroscopic Elbow Contracture Release: Improvement for Severe Prosupination and Flexion Contracture

Arthroscopy. 2022 Feb;38(2):315-322. doi: 10.1016/j.arthro.2021.07.020. Epub 2021 Jul 27.

Abstract

Purpose: The purpose of this study was to investigate outcomes following arthroscopic elbow contracture release to describe the use of arthroscopy for improvement in extension/flexion and pronation/supination arcs of motion at a single institution for degenerative and posttraumatic etiologies.

Methods: Consecutive arthroscopic elbow arthrolysis performed between 2003 and 2015 were retrospectively reviewed. Basic patient demographics, indications for surgery, preoperative and postoperative elbow range of motion, postoperative patient outcome score, and all complications were recorded and analyzed.

Results: Fifty-two patients were included with an average follow-up of 5.1 years (range 1.4 to 9.4). Severe contractures made up 50% of cases, followed by 23% moderate, and 27% mild. Average extension/flexion for the post-traumatic group (n = 30) increased by 63° ± 31 and by 29° ± 24 for the degenerative group (n = 22). Average gain in pronosupination was 38° ± 62 in the post-traumatic group and 13°±23 in the degenerative group. Postoperative DASH scores were 17.5 ± 18.4 for post-traumatic cases and 12.8 ± 19.3 for degenerative cases.

Conclusion: Arthroscopic elbow contracture release is an effective intervention for degenerative and post-traumatic elbow contracture for both flexion/extension and pronosupination contracture. Furthermore, a two-stage release should be considered when both flexion and pronosupinaton contractures are present.

Level of evidence: IV, case series, treatment study.

Keywords: arthrolysis; arthroscopy; elbow contracture; elbow stiffness; extension contracture; flexion contracture; posttraumatic elbow; pronosupination contracture.

MeSH terms

  • Arthroscopy / adverse effects
  • Contracture* / etiology
  • Contracture* / surgery
  • Elbow
  • Elbow Joint* / surgery
  • Humans
  • Range of Motion, Articular
  • Retrospective Studies
  • Treatment Outcome