PURPOSE: Elbow contracture is a common and difficult problem to manage. The purpose of this study was to determine the functional outcomes of arthroscopic capsular release in the management of elbow contractures. METHODS: A total of 22 patients (14 males, 8 females; mean age, 42 years) undergoing arthroscopic contracture release were retrospectively reviewed at a minimum follow-up of 1 year (mean, 25 months). In all, 20 patients had a capsulectomy, and 2 underwent capsulotomy. Patient-rated questionnaires (Disability of the Arm, Shoulder, and Hand questionnaire [DASH], American Shoulder and Elbow Surgeons Elbow Form [ASES-e], and Short Form-36 [SF-36]) and clinical, radiographic, and objective evaluations were used to assess outcomes. Motion and strength were measured by independent evaluators through standard goniometry and the LIDO Isokinetic System (Loredan Biomedical, West Sacramento, CA). RESULTS: Mean flexion significantly improved from 122 degrees +/- 15 degrees to 141 degrees +/- 12 degrees (P < .001). Mean extension significantly improved from 38 degrees +/- 18 degrees to 19 degrees +/- 13 degrees (P < .001). Mean arc improvement was 38 degrees +/- 23 degrees (P < .001). None of the patients had instability, and no major neurovascular complications were reported. All patients had improved elbow function with a mean ASES-e score of 31 out of 36. Most patients were satisfied with their surgery, experienced minimal pain, and exhibited minimal impairment on the DASH. CONCLUSIONS: Arthroscopic debridement and capsulectomy of the contracted elbow is effective. Results are comparable with those of other reports in the literature in which both arthroscopic and open methods were used. LEVEL OF EVIDENCE: Level IV.
PURPOSE:Elbow contracture is a common and difficult problem to manage. The purpose of this study was to determine the functional outcomes of arthroscopic capsular release in the management of elbow contractures. METHODS: A total of 22 patients (14 males, 8 females; mean age, 42 years) undergoing arthroscopic contracture release were retrospectively reviewed at a minimum follow-up of 1 year (mean, 25 months). In all, 20 patients had a capsulectomy, and 2 underwent capsulotomy. Patient-rated questionnaires (Disability of the Arm, Shoulder, and Hand questionnaire [DASH], American Shoulder and Elbow Surgeons Elbow Form [ASES-e], and Short Form-36 [SF-36]) and clinical, radiographic, and objective evaluations were used to assess outcomes. Motion and strength were measured by independent evaluators through standard goniometry and the LIDO Isokinetic System (Loredan Biomedical, West Sacramento, CA). RESULTS: Mean flexion significantly improved from 122 degrees +/- 15 degrees to 141 degrees +/- 12 degrees (P < .001). Mean extension significantly improved from 38 degrees +/- 18 degrees to 19 degrees +/- 13 degrees (P < .001). Mean arc improvement was 38 degrees +/- 23 degrees (P < .001). None of the patients had instability, and no major neurovascular complications were reported. All patients had improved elbow function with a mean ASES-e score of 31 out of 36. Most patients were satisfied with their surgery, experienced minimal pain, and exhibited minimal impairment on the DASH. CONCLUSIONS: Arthroscopic debridement and capsulectomy of the contracted elbow is effective. Results are comparable with those of other reports in the literature in which both arthroscopic and open methods were used. LEVEL OF EVIDENCE: Level IV.
Authors: Michael Hackl; Sebastian Lappen; Klaus J Burkhart; Tim Leschinger; Martin Scaal; Lars P Müller; Kilian Wegmann Journal: Clin Orthop Relat Res Date: 2015-07-08 Impact factor: 4.176