Elbow arthrolysis for traumatic arthrofibrosis: a shift towards minimally invasive surgery

The elbow joint needs to be both mobile and stable to exercise its hinge function, which is the key to a normal upper limb. Loss of motion in the elbow joint leads to an exponential functional handicap. Elbow trauma is a common cause of elbow stiffness. Open elbow arthrolysis with release of the capsule has been demonstrated to be a very useful treatment. Arthroscopic elbow arthrolysis has now gained popularity, along with the rapid evolution in elbow arthroscopy. The authors present the preliminary results of this technique in 12 patients, with a mean follow-up of 19.4 months. The range of motion significantly increased from an extension lag of 39.2 degrees and a flexion limited to 115 degrees to an extension lag of 17.9 degrees and a flexion of 131.7 degrees. On average, a 38 degrees gain in range of motion was achieved. This result is comparable with a gain of 40 degrees after open arthrolysis, reported by the senior author in a previous study. The DASH score improved from 39 to 28, but not significantly, and the VAS for pain from 5.5 to 3.4 (significantly). All patients would undergo the procedure again and they experienced a mean subjective improvement of 63.6%. A literature review showed that open and arthroscopic arthrolysis yield a gain of about 44.10 degrees and 31.25 degrees, respectively. The conclusion is that there certainly is a place for arthroscopic elbow arthrolysis.