Post-traumatic elbow stiffness: etiology, risk factors and current treatments.

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Abstract

Conflict of interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. 15. Orthop Traumatol Surg Res. 2015 Oct;101(6):735-9. doi: 10.1016/j.otsr.2015.07.009. Epub 2015 Aug 28. Arthroscopic elbow joint release with radial head resection arthroplasty: 12 cases. Bornu BC(1), Clément X(1), Kempf JF(1), Clavert P(2). Author information: (1)Centre de chirurgie orthopedique et de la main, 10, avenue Achille-Baumann, 67400 Illkirch-Graffenstaden, France. (2)Centre de chirurgie orthopedique et de la main, 10, avenue Achille-Baumann, 67400 Illkirch-Graffenstaden, France. Electronic address: philippe.clavert@chru-strasbourg.fr. BACKGROUND: Elbow arthritis typically affects manual labourers aged 40 to 50 years and usually starts in the lateral compartment. The objective of this study was to evaluate the medium-term clinical, functional, and radiological outcomes in 12 patients after arthroscopic elbow joint release and radial head resection arthroplasty. HYPOTHESIS: Our main hypothesis was that pre-operative damage to the radio-capitellar joint was associated with poorer clinical outcomes after elbow joint release. MATERIAL AND METHOD: Consecutive patients treated by a single surgeon at a single centre between July 2006 and May 2014 were studied retrospectively. The 12 patients - 10 males and 2 females with a mean age of 54.5±9.3 years (33-69 years) - had osteoarthritis confined to the radio-capitellar compartment with elbow stiffness and pain and underwent arthroscopic elbow joint release with radial head resection arthroplasty. Among them, 9 had a history of trauma or micro-trauma and 3 had rheumatoid arthritis. The Broberg and Morrey osteoarthritis grade on the pre-operative radiographs was 1 in 4 patients, 2 in 6 patients, and 3 in 2 patients. RESULTS: Mean follow-up was 38.1±33.7 months (5-97). One patient required total elbow arthroplasty. Mean arc of motion was 79.6°±20.5° (30-110) pre-operatively, 123.6±18° (90-140) immediately after surgery, and 109°±11.7° (90-120) at last follow-up. At last follow-up, mean values were 81.4±12.5 (65-100) for the Mayo Elbow Score, 11.1±11.1 (2.3-31.8) for the Quick DASH score, and 1.1±1.6 (0-4) for the visual analogue scale pain score. The radiological assessment at last follow-up showed no evidence of osteoarthritis progression. CONCLUSION: In our case-series, arthroscopic elbow joint release with radial head resection arthroplasty produced good outcomes with a motion arc greater than 100° and little or no pain after a mean follow-up of 3.1 years. LEVEL OF EVIDENCE: IV, retrospective study. Copyright © 2015 Elsevier Masson SAS. All rights reserved. DOI: 10.1016/j.otsr.2015.07.009