Arthroscopic Osteocapsular Arthroplasty for Elbow Osteoarthritis

The elbow joint is particularly prone to stiffness due to its highly congruent bony anatomy, the presence of three distinct articulations within the same synovial cavity, and the close relationship between the joint capsule, ligaments, and surrounding musculature [1, 2]. The principal biological mechanism underlying the elbow’s propensity for contracture is the capsule’s tendency to undergo an inflammatory process, as observed in osteoarthritis [3]. Various anatomical factors can limit extension and flexion, as described in Fig. 19.1. Anteriorly, elbow extension can be restricted by contracture of the skin, flexor muscles, or the anterior capsule. Posteriorly, it can be limited by bony impingement. Elbow flexion can be restricted posteriorly by contracture of the triceps, posterior capsule, or the posterior band of the medial collateral ligament, and anteriorly by osseous impingement. Additionally, ulnar nerve neuropathy can indirectly contribute to contracture, as the resulting pain will restrict the patient’s ability to mobilize the elbow [4].