Abstract
Purpose: This retrospective analysis was designed to determine the contribution of arthroscopy in the management of moderately stiff elbows arising from degenerative disease or trauma.
Material and methods: Between 1992 and 2001, we performed 31 arthroscopic examinations of the elbow in patients with moderately stiff elbows. Mean preoperative motion was 94.8°. Men age at surgery was 41.6 years; there were nine women and 22 men. The dominant side was involved in 70% of the cases. Twentyfive patients were available for clinical review at a mean 32 months follow-up (range 5 months to 9 years). The causal event was trauma in 13 cases. The stiff elbow was a consequence of degenerative disease in 13 cases with no notion of trauma. Three elbows had been exposed to repeated microtrauma. For the majority of the cases, the intervention consisted in an anterior time via two portals then a posterior time. In five cases, anterior capsulotomy was performed. The other interventions were limited to joint cleaning. For two elbows, we used the Kashiwagi Outerbridge technique. Neurolysis of the ulnar nerve was performed at the elbow level during the same operative time.
Results: Elbow motion in flexion was significantly improved after arthroscopy (P=0.01) and the flexion of the stiff elbow was reduced significantly (P=0.0001). At last follow-up none of the patients felt arthroscopy had worsened the elbow condition. The gain in joint motion was 25°. This gain was significantly greater when we performed anterior capsulotomy at the end of the procedure (P< 0.001). In three cases, there was a postoperative loss of motion. We did not have any intra or postoperative complications. Eighty percent of the patients felt arthroscopy had improved their elbow.
Discussion: Arthroscopy of the stiff elbow arising from variable causes remains a difficult intervention which in our series provided gain in motion comparable to that reported in other series in the literature. This could be an interesting less invasive alternative to open surgery in the case of moderately stiff elbow.
The abstracts were prepared by Docteur Jean Barthas. Correspondence should be addressed to him at Secrétariat de la Société S.O.F.C.O.T., 56 rue Boissonade, 75014 Paris.
