Patterns of management for post-traumatic elbow stiffness: A comparative study of open and arthroscopic approaches

Post-traumatic elbow stiffness (PTES) often results in significant functional impairment. Open elbow arthrolysis (OEA) and arthroscopic elbow arthrolysis (AEA) are two surgical management options. This study aimed to compare the incidence, demographics, and treatment patterns of patients with PTES undergoing OEA and AEA from 2014 to 2023.

A retrospective analysis was conducted using the TriNetX database. Patients diagnosed with elbow stiffness (ICD-10 codes M25.621, M25.622, M25.629) were included. Rates of OEA (CPT 24149, 24006) and AEA (CPT 29837, 29838) were identified. Demographic characteristics and simultaneous surgical procedures were assessed.

A total of 30,624 patients were diagnosed with PTES, with 848 undergoing OEA (2.8%) and 361 undergoing AEA (1.2%). The mean age for OEA patients was 44.3 ± 17.6 years, while AEA patients had a mean age of 37.9 ± 18.9 years. OEA was more common in males (61.2%) and non-Hispanic/Latino patients (68.3%). AEA showed higher rates in younger patients and non-Hispanic/Latino individuals (72.7%).

The study highlights a preference for OEA in older patients with complex conditions, while AEA is more common in younger patients. Despite the growing trend toward minimally invasive techniques, OEA remains prevalent. Further research is needed to understand the drivers of these trends.