Universität zu Köln

Lanzerath, Fabian ORCID: 0000-0002-4780-6875, Wegmann, Kilian, Hackl, Michael, Uschok, Stephan, Ott, Nadine, Mueller, Lars P. and Leschinger, Tim (2023). Surgical arthrolysis of the stiff elbow: a systematic review. Arch. Orthop. Trauma Surg., 143 (5). S. 2383 - 2394. NEW YORK: SPRINGER. ISSN 1434-3916

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Abstract

Introduction Stiffness after elbow injuries can severely limit daily life. If adequate conservative treatment does not result in satisfactory improvement of elbow function, surgical intervention should be considered. Whether an open or arthroscopic procedure is preferable is still a topic of debate and a systematic review of functional outcomes is lacking. Materials and methods We systematically reviewed the available literature searching electronic databases, MEDLINE using the PubMed interface and EMBASE, for studies published between 2013 and 2021. Primary objective was to compare open and arthroscopic arthrolysis' functional outcomes, respectively, especially ROM and MEPS, as well as the accompanied complications. The PRISMA guidelines were applied. Results 27 studies comprising 1666 patients were included. 1059 patients (63.6%) were treated with open arthrolysis, and 607 patients (36.4%) were treated with arthroscopic arthrolysis. The results presented indicate satisfactory outcomes in open and arthroscopic arthrolysis with regard to functional outcome parameters. Treatment success, defined as excellent or good results according to the Mayo Elbow Performance Score, among the patients treated with an open procedure was 88.8%; 6.3% required revision whereas 18.1% had complications without the need for revision surgery. Within the cohort of arthroscopically treated patients, treatment success was 91.8%. Revisions and complications without further surgical intervention were significantly less frequent than in the open cohort, at 1.6% and 9.1%, respectively. Conclusions Both open and arthroscopic arthrolysis provide good to excellent functional outcomes. Since the number of complications and revision increases with the invasiveness of the treatment, an arthroscopic procedure might be favored if feasible by indication. The role of forearm rotation and the use of a hinged external fixator remains of interest. Study design Level IV; Systematic review.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lanzerath, Fabian UNSPECIFIED orcid.org/0000-0002-4780-6875 UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Hackl, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Uschok, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Ott, Nadine UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Lars P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leschinger, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-657255
DOI:	10.1007/s00402-022-04442-0
Journal or Publication Title:	Arch. Orthop. Trauma Surg.
Volume:	143
Number:	5
Page Range:	S. 2383 - 2394
Date:	2023
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1434-3916
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HINGED EXTERNAL FIXATOR; COMPLETE OPEN RELEASE; POSTTRAUMATIC CONTRACTURE; ARTHROSCOPIC ARTHROLYSIS; FUNCTIONAL OUTCOMES; FRACTURE; RECONSTRUCTION; MOTION; RANGE Multiple languages Orthopedics; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/65725