EVALUATION OF FUNCTIONAL OUTCOME AND PATIENT SATISFACTION AFTER ARTHROSCOPIC ELBOW ARTHROLYSIS

Authors: Somanchi & L Funk

References: Presented at North-West Musculoskeletal Clinical Research & Audit Symposium, 10 March 2006

Abstract
Introduction: Arthroscopic arthrolysis is indicated for stiffness and pain caused by intrinsic stiffness and early arthritis of the elbow joint. Previous studies have demonstrated the benefits in relieving pain and improving motion, but none have reported the specific functional recovery.

Aims: To review the functional outcome and patient satisfaction in a series of patients who underwent arthroscopic elbow arthrolysis for intrinsic stiffness, pain and arthritis not suitable for arthroplasty.

Materials and methods: Twenty six patients who underwent arthroscopic arthrolysis over a three year period were included. All patients were manual workers or strength athletes. All had pain and stiffness secondary to primary or secondary arthritis, with or without loose bodies. Pre- and post-operative evaluation included the Elbow Functional Assessment score, patient satisfaction and return to work and sports. The mean follow up period was 22 months.

Results: Function improved significantly in 87% with overall improvement in the Elbow Functional Assessment score from a preoperative score of 48 to a postoperative score of 84 (p<0.05). All except three patients returned to their desired level of activity by 3 months postoperatively. Pain improved in 91%, mechanical symptoms in 80%, stiffness in all except one. The arc of elbow movement improved from 106º to 124º with a mean gain in elbow extension of 13º. Mayo elbow performance index also significantly improved postoperatively. Overall, 87% patients were very satisfied with the outcome.

Conclusion: Arthroscopic arthrolysis improves elbow function and returns patients to their desired level of activity, as well as improving range of motion and pain in patients with intrinsic elbow stiffness and pain.