Elbow arthrolysis is an operation to release a stiff elbow by removing scar tissue, bone spurs, and contractured capsule. It may be performed open or arthroscopically to restore a functional range of motion.
Arthroscopic arthrolysis: the joint is accessed through small incisions. Scar tissue, thickened capsule, and bone spurs are removed under camera guidance. Open arthrolysis: a larger incision allows direct access for more severe contractures. Heterotopic bone may be excised. The operation takes one to two hours.
Arthrolysis is recommended when elbow stiffness significantly limits function — typically when the arc of motion is less than 100 degrees (less than 30-130 degrees) — and has not improved with physiotherapy and splinting.
Physiotherapy, serial splinting (static progressive or dynamic), and time. Many post-traumatic stiff elbows improve with dedicated rehabilitation.
CT scan to assess bony anatomy and heterotopic ossification. Standard pre-assessment.
Improvement in range of motion, typically gaining 30-40 degrees of additional motion. Maintaining the gains requires dedicated post-operative physiotherapy.
Scar tissue may reform. Aggressive physiotherapy is essential.
Expected after surgery.
Ulnar nerve and other nerves are at increased risk due to scarring. Occurs in approximately 2-5%.
New unwanted bone may form. Preventive measures may be used.
Joint infection.
Weakened bone may fracture during manipulation.
General anaesthesia with a regional nerve block for early pain-free exercises.
Intensive physiotherapy begins on the day of surgery. Continuous passive motion (CPM) machines may be used. Splinting between exercise sessions. NSAIDs or radiotherapy may be used to prevent heterotopic ossification. Full recovery three to six months.
Frequent early reviews to monitor range of motion progress.
The elbow forms scar tissue rapidly. The gains from surgery must be maintained with immediate, intensive movement. Delay allows new scar tissue to form.