A comparative analysis of short-term results in range of motion following arthroscopic arthrolysis with vs. without peripheral nerve block in cases of elbow stiffness

Abstract

Background

This study aimed to investigate the clinical short-term results in patients with elbow stiffness, particularly focusing on the range of motion (ROM) following arthroscopic arthrolysis. Our objective was to assess potential differences in postoperative outcomes between patients who received an additional peripheral nerve block with postoperative nerve block catheter, and those who exclusively underwent general anesthesia at 6 weeks, 3 months, and 6 months after surgery.

Methods

A single-center study was performed on patients undergoing arthroscopic elbow arthrolysis due to persistent elbow stiffness between 2014 and 2018. The participants were divided into 2 cohorts: One underwent arthroscopic elbow arthrolysis with an additional peripheral nerve block, combined with a postoperative nerve block catheter (group 1), while the other received the procedure without peripheral nerve block (group 2). Standardized assessments of ROM and the Disabilities of the Arm, Shoulder, and Hand score were conducted and analyzed preoperatively and at the 6-week, 3-month, and 6-month follow-up.

Results

A total of 32 patients were included in this study. In group 1 (18 patients), ROM in extension/flexion improved significantly from 95° (±27.17) to 124.4° (±12.7°; P = .000012) after 6 months. Similarly, a significant improvement from 150° (±29.1) to 170.6° (±13°; P = .0013) was observed after 6 months for ROM in pronation/supination. In contrast, group 2 (14 patients) demonstrated an improvement in elbow motion after 6 months, compared to preoperative values, although this increase did not reach statistical significance after 6 months (ROM extension/flexion, P = .6016; ROM pronation/supination, P = .2461). Furthermore, a significant difference (P = .0199) in the delta values of ROM arc for extension/flexion before surgery and after 6 months was identified when comparing both groups, favoring the patient group with additional regional anesthesia (group 1).

Conclusion

Additional peripheral nerve block combined with a postoperative nerve block catheter in arthroscopic arthrolysis in cases of elbow stiffness may be an opportunity to enhance postoperative outcomes by achieving better functional ROM, perhaps through reduced postoperative pain.