Serial Comparison of Clinical Outcomes After Arthroscopic Circumferential Release for Severe and Nonsevere Posttraumatic Elbow Stiffness
Jia Guo, Erica Kholinne, Hui Ben, Hyun-Ki Lee, In-Ho JeonBackground:
Arthroscopic release is increasingly used to treat posttraumatic elbow stiffness. However, severe stiffness remains controversial due to technical challenges and concerns about neurovascular injury.
Purpose/Hypothesis:
The purpose of this study was to compare the serial recovery of range of motion (ROM), patient-reported outcomes, and complication rates after arthroscopic circumferential release between patients with severe and nonsevere posttraumatic elbow stiffness. It was hypothesized that comparable outcomes could be achieved regardless of the preoperative severity of elbow stiffness.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A retrospective cohort study was conducted of 46 patients who underwent arthroscopic circumferential release for posttraumatic elbow stiffness between 2018 and 2024. Patients were stratified into a severe group (preoperative flexion-extension arc <60°; n = 18) and a nonsevere group (≥60°; n = 28). ROM, Visual Analog Scale (VAS), Mayo Elbow Performance Score (MEPS), Quick Disabilities of the Arm, Shoulder and Hand, and Single Assessment Numeric Evaluation (SANE) scores were assessed preoperatively and at 3, 6, and ≥12 months postoperatively. Linear mixed-effects models were used to evaluate serial postoperative recovery trajectories. Multivariable logistic regression analysis was performed to identify predictors of achieving a functional arc of motion (≥120°). Complications and revision procedures were recorded.
Results:
At a mean follow-up of 22.5 months, both groups demonstrated significant improvements in ROM, pain, and functional outcomes compared with preoperative values (all
Conclusion:
Arthroscopic circumferential release resulted in comparable functional recovery, pain relief, and final ROM in patients with severe and nonsevere posttraumatic elbow stiffness. Severe preoperative stiffness was not associated with inferior outcomes when a standardized circumferential release protocol was used.