Treatment of the Stiff Arthritic Elbow

Elbow contractures from both extrinsic and intrinsic factors result in functional disability and are challenging to treat. Several surgical approaches have been suggested for treatment, although the optimal method is still debated. Nonsurgical management is generally considered for up to 6 months after the onset of the contracture. Surgical treatment is guided by the etiology and severity of the contracture, patient age, and functional demands. Arthroscopic or open release is generally recommended for young and active patients. In cases with primary osteoarthritis, which are often associated with pain at extremes of motion and relative preservation of articular cartilage, arthroscopic osteocapsular debridement and open ulnohumeral arthroplasty are viable management options. Total elbow arthroplasty is considered for low-demand and older patients with pain throughout the range of motion.