A retrospective comparison of open and arthroscopic surgery for elbow joint stiffness; a single centre pragmatic study over 15 years

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-04-23 DOI:10.1016/j.jcot.2025.103031

Andrew P Dekker , Jamie Hind , Neil Ashwood

{"title":"A retrospective comparison of open and arthroscopic surgery for elbow joint stiffness; a single centre pragmatic study over 15 years","authors":"Andrew P Dekker , Jamie Hind , Neil Ashwood","doi":"10.1016/j.jcot.2025.103031","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>There is ample evidence but conflicting reports to justify decision making for open versus arthroscopic elbow debridement and release for stiffness and pain once non-surgical measures have failed. The aim of this retrospective study is to report the clinical and functional outcomes of arthroscopic and open surgery for patients presenting with elbow pain, stiffness and loss of function.</div></div><div><h3>Methods</h3><div>A consecutive series of patients who had completed a minimum of 6 months of non-surgical treatment of elbow stiffness were identified over a 15-year period between July 2008 and January 2023 from a single centre.</div></div><div><h3>Results</h3><div>96 patients were treated with arthroscopic surgery with 75 open surgery. Mean age was 51 years. Pre-operative pathology included osteoarthritis, inflammatory arthropathy and post-traumatic stiffness. Post-traumatic stiffness was more commonly treated with open surgery. The flexion-extension arc, pronosupination arc, pain score, Mayo elbow performance score (MEPS) and satisfaction scores improved in all patients (p < 0.05). The arthroscopic group had a lower pain score (p < 0.05), a higher satisfaction score (p < 0.05), higher MEPS (p < 0.05), greater flexion-extension arc (P < 0.01), greater pronosupination arc (P < 0.01) and fewer patients had ongoing symptoms of pain and stiffness which limited function (P < 0.05) with fewer repoerations (p > 0.05) than the open group.</div></div><div><h3>Conclusions</h3><div>Both arthroscopic and open surgical approaches for elbow stiffness improved elbow range of movement and function. Arthroscopic treatment was better than open surgery and may represent a more favorable approach.</div></div><div><h3>Level of evidence</h3><div>Level 4 (case series)</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 103031"},"PeriodicalIF":0.0000,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Orthopaedics and Trauma","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0976566225001286","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Background

There is ample evidence but conflicting reports to justify decision making for open versus arthroscopic elbow debridement and release for stiffness and pain once non-surgical measures have failed. The aim of this retrospective study is to report the clinical and functional outcomes of arthroscopic and open surgery for patients presenting with elbow pain, stiffness and loss of function.

Methods

A consecutive series of patients who had completed a minimum of 6 months of non-surgical treatment of elbow stiffness were identified over a 15-year period between July 2008 and January 2023 from a single centre.

Results

96 patients were treated with arthroscopic surgery with 75 open surgery. Mean age was 51 years. Pre-operative pathology included osteoarthritis, inflammatory arthropathy and post-traumatic stiffness. Post-traumatic stiffness was more commonly treated with open surgery. The flexion-extension arc, pronosupination arc, pain score, Mayo elbow performance score (MEPS) and satisfaction scores improved in all patients (p < 0.05). The arthroscopic group had a lower pain score (p < 0.05), a higher satisfaction score (p < 0.05), higher MEPS (p < 0.05), greater flexion-extension arc (P < 0.01), greater pronosupination arc (P < 0.01) and fewer patients had ongoing symptoms of pain and stiffness which limited function (P < 0.05) with fewer repoerations (p > 0.05) than the open group.

Conclusions

Both arthroscopic and open surgical approaches for elbow stiffness improved elbow range of movement and function. Arthroscopic treatment was better than open surgery and may represent a more favorable approach.

Level of evidence

Level 4 (case series)

查看原文本刊更多论文

开放性手术与关节镜下手术治疗肘关节僵硬的回顾性比较一项历时15年的单中心语用学研究

背景：有充分的证据，但相互矛盾的报告证明，在非手术措施失败后，应选择开放还是关节镜下的肘关节清创和解除僵硬和疼痛。本回顾性研究的目的是报告关节镜和开放手术治疗肘部疼痛、僵硬和功能丧失患者的临床和功能结果。方法在2008年7月至2023年1月的15年间，从单一中心确定了完成至少6个月非手术治疗肘关节僵硬的连续系列患者。结果96例患者均行关节镜手术，其中开放手术75例。平均年龄51岁。术前病理包括骨关节炎、炎性关节病和创伤后僵硬。创伤后僵硬更常用开放手术治疗。所有患者的屈伸弧度、旋前弧度、疼痛评分、Mayo肘关节功能评分（MEPS）和满意度评分均有改善(p <；0.05)。关节镜组疼痛评分较低(p <；0.05)，满意度得分较高(p <；0.05)，较高的MEPS (p <；0.05)，更大的屈伸弧度(P <；0.01)，旋前弧度较大(P <；0.01)，有持续疼痛和僵硬症状限制功能的患者较少(P <；0.05)，但重复性较低(p >；0.05)。结论关节镜下和开放手术均可改善肘关节的活动范围和功能。关节镜治疗优于开放手术，可能是更有利的方法。证据等级4级（案例系列）

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.