Arthroscopic treatment of nontraumatic elbow ankylosis
Young-Lae Moon, Dong-Hui Kim, Sang-Hong Lee, Jae-Won You
Department of Orthopedics Surgery, Chosun University, Gwangju, Korea
Keywords: Arthroscopy/methods; contracture/surgery; elbow joint/injuries/surgery; joint diseases/etiology; range of motion, articular.
Objectives: This study was designed to evaluate the results of arthroscopic treatment for nontraumatic elbow contractures with the removal of osteophytes and loose bodies of the olecranon process and olecranon fossa.
Patients and methods: Twenty-one patients with ankylosis of the elbow due to degenerative causes were treated with elbow arthroscopy. All the patients were males and the mean age was 43.2 years (range 37 to 54 years). Osteophytectomy of the olecranon process and olecranon fossa was performed in all the cases and additionally, posterior capsular release was performed in six cases. On presentation, the main complaint was limitation of motion accompanied by pain. The mean range of motion was 17° (range 5°-60°) in flexion contractures and 87° (range 60°-100°) in further flexion. The results were evaluated using the Broberg and Morrey's functional scoring system. The mean follow-up period was 18 months (range 12 to 24 months).
Results: The mean flexion contracture improved from 17° to 3° and further flexion from 87° to 122° during the first postoperative two months. The mean flexion contracture was 5° and further flexion was 113° at the end of a year follow-up. There was no pain upon movement within the final articular range of motion. The mean functional scores were 65 (range 61 to 72) and 80.7 (range 78 to 91) before and a year after the treatment, respectively. The results were good in 18 patients (85.7%) and moderate (14.3%) in three patients. No postoperative complications were encountered.
Conclusion: Selective removal of the lesion causing elbow contracture can be successfully performed through arthroscopic surgery with minimal morbidity.