[Arthroscopic arthrolysis of the elbow joint]. / Die arthroskopische Arthrolyse des Ellenbogengelenks.

ABSTRACT

OBJECTIVE: Arthroscopic assisted improvement of range of motion in elbow stiffness. Detailed diagnostic evaluation including medical history and preoperative radiographs, CT and MRI scans are necessary for planning the operative treatment. INDICATIONS Restricted range of motion < 30° in extension and/or more than 100° in flexion related to intraarticular causes (loose bodies, osteophytes or contracture of the capsule). CONTRAINDICATIONS Extension deficit > 30°, extraarticular causes (e.g., heterotopic ossifications), nerve irritation, incongruity of joint surfaces, acute joint infection. SURGICAL TECHNIQUE Prone position, filling of the joint with irrigation fluid, arthroscopic examination of the anterior and posterior compartment. Partial synovectomy, debridement and capsular release, removal of loose bodies and resection of osteophytes. POSTOPERATIVE MANAGEMENT Intensive physiotherapy, continuous passive motion. Plexus anesthesia and nonsteroidal antiphlogistic medication. RESULTS: A total of 29 patients who underwent arthroscopic arthrolysis of the elbow joint were evaluated after a mean follow up of 15.4 months after surgery. Average preoperative extension deficit improved from 23° to 5°. Mean preoperative flexion improved from 115° to 131°. Improvement of range of motion was 34° on average. No vascular or neurologic complications were noted. Infection was not observed. In one case, stiffness persisted and early arthroscopic revision was needed. Postoperative patient satisfaction on the VAS Scale was 8.9. The Mayo Elbow Performance Index was 92.9 points on average.