[Arthroscopic therapy in limited mobility of the elbow joint]

Limitation of elbow mobility constitutes a grave problem for therapy. Arthroscopy offers a therapeutic option, but in cases of loss of motion poses a considerable challenge to the operative technique. Placement of the portals already carries an increased risk of neurovascular lesions due to the altered anatomy and reduced distension capacity of the joint. Thus, particular significance attaches to the standardized arthroscopic procedure for localization and placement of the cannulas, intra-articular assessment, differentiated evaluation of the dorsal joint regions, and operative tactics for transsection of cicatrization, removal of loose bodies, and excision of osteophytes. If extra-articular factors are involved in the genesis of the limited motion, arthroscopic treatment often does not achieve the desired result. It is therefore considered propitious to differentiate the causes of the loss of motion during clinical examination with imaging diagnostics, in particular to determine those caused by extra-articular elements. If, however, individually localized intra-articular adhesive bands or loose bodies are responsible, the prognosis for arthroscopic management is clearly more favorable. Patients with minor loss of motion (> 15 degrees) profit more from the arthroscopic operation than those with a extension or flexion deficit of more than 30 degrees.