Arthroscopic arthrolysis leads to improved range of motion and health-related quality of life in post-traumatic elbow stiffness

Background: Post-traumatic elbow stiffness is a frequent and disabling complication after elbow trauma. Surgical release is needed if conservative treatment fails. In contrast to open surgical release, arthroscopic arthrolysis is a good and least invasive option to restore joint mobility. The aim of this study was to evaluate the clinical outcomes, range of motion (ROM), and function of post-traumatic elbow contracture after arthroscopic arthrolysis and to assess health-related quality of life (HRQL). Methods: Between 2007 and 2013, 44 patients with post-traumatic elbow stiffness were treated by arthroscopic arthrolysis and followed up in a consecutive series. Clinical (ROM) and functional analyses (Disabilities of the Arm, Shoulder, and Hand Questionnaire [DASH], Mayo Elbow Performance Index [MEPI]) were performed at final follow-up 3 (1-7) years postoperatively. Furthermore, HRQL was evaluated (EQ-5D, 36-Item Short Form Health Survey [SF-36]). Discussion: The average arc of elbow motion increased from 84 degrees +/- 28 degrees preoperatively to 120 degrees +/- 18 degrees postoperatively. All applied scores significantly improved pre- to postoperatively: the MEPI (59.8 +/- 17.3 / 84.3 +/- 14.0), DASH (43.5 +/- 23.1 / 16.8 +/- 15.6), EQ-5D (72.8 +/- 16.6 / 84.0 +/- 13.6), and SF-36 showed improved results in all categories. Univariate logistic regression revealed that preoperative pain level predicts a poorer postoperative outcome measured with the MEPI score. Revision arthroscopy was needed in 1 case because of persistent pain. Conclusions: Arthroscopic arthrolysis leads to good clinical and functional results in post-traumatic elbow stiffness regarding ROM, pain relief, functionality, and quality of life. The complication rate as well as the revision rate is very low. (C) 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.