Arthroscopic arthrolysis provides good clinical outcome in post-traumatic and degenerative elbow stiffness

作者:Willinger Lukas; Siebenlist Sebastian; Lenich Andreas; Liska Franz; Imhoff Andreas B*; Achtnich Andrea
来源:Knee Surgery, Sports Traumatology, Arthroscopy, 2018, 26(1): 312-317.
DOI:10.1007/s00167-017-4630-7

摘要

The purpose of this retrospective study was to report on the functional outcome after arthroscopic arthrolysis in patients with post-traumatic or degenerative elbow stiffness. It was hypothesized that this operative procedure leads to improved range of motion (ROM) and improved functional outcome in both groups.
Patients who underwent arthroscopic arthrolysis of the elbow between 2010 and 2015 were included in this study. Forty-two patients with an average age of 41.0 +/- 13.5 years were available for evaluation. The mean follow-up was 28.3 +/- 14.9 months. With regard to aetiology of elbow contractures, patients were divided into post-traumatic (group A) and degenerative (group B) cohort. General patients' data, previous surgical treatment and ROM were recorded. At follow-up evaluation, the clinical outcome was assessed by the ROM, visual analogue scale (VAS) for pain assessment and the Elbow Self-Assessment Score (ESAS).
The mean arc of motion of group A (n = 20) increased from preoperatively 74.3A degrees to 120.5A degrees postoperatively (p < 0.001); group B (n = 22) showed an improvement of 104.6A degrees preoperatively to 123.4A degrees after surgery (p = 0.002). Mean improvement was 46.3A degrees A +/- 27.5A degrees in group A and 16.4A degrees A +/- 19.4A degrees in group B. Mean post-operative VAS was 0.9 +/- 1.5 in group A and 1.3 +/- 2.2 in group B. 92.9% of patients achieved a functional arc of elbow motion > 100A degrees. The ESAS indicated good to excellent clinical outcome showing 88.8 +/- 10.0 points in group A and 84.1 +/- 21.4 points in group B. Thirty-six patients (85.7%) returned to their previous work level after surgery.
Arthroscopic arthrolysis is an effective treatment option for patients with restriction in elbow motion reasoned by post-traumatic or degenerative changes. Both groups showed a significant improvement of ROM and comparable outcome scores.
Therapeutic study, Level IV.

  • 出版日期2018-1