600 Section - Elbow Arthrolysis Restores Function Beyond Range of Motion: Disability, Autonomy and Return-to-Work Outcomes

Elbow stiffness, either post-traumatic or secondary to neurogenic paraosteoarthropathy (PAON), can markedly reduce upper-limb function and restrict participation in daily life and work. Although elbow arthrolysis improves joint mechanics, the extent to which these gains translate into disability reduction, autonomy, quality of life, and occupational reintegration in real-world rehabilitation settings remains variable. This study aimed to evaluate long-term functional outcomes after elbow arthrolysis followed by standardized inpatient rehabilitation, and to quantify residual participation restrictions, particularly return to work.

Design:

Retrospective observational cohort conducted in a Physical Medicine and Rehabilitation department (CHU Ibn Rochd, Casablanca). Thirty-six patients who underwent elbow arthrolysis and subsequently received standardized inpatient rehabilitation were included (post-traumatic n=26; PAON n=10). Mean follow-up was 18 months (12–24). Outcomes were assessed before rehabilitation and at follow-up using pain (VAS), elbow mobility (flexion, extension deficit, range of motion), disability (QuickDASH), elbow function (Mayo Elbow Performance Score, MEPS), autonomy (Functional Independence Measure, FIM), health-related quality of life (SF-12 physical and mental component scores), and occupational status (return to previous job). No control group was available.

Results:

Mean age was 30.9±9.3 years; 50% were women. Pain decreased (VAS 6.2→1.6). Flexion improved (75.8°→108.3°), extension deficit decreased (−29.7°→−7.2°), and range of motion increased (105.6°→115.6°). Disability improved (QuickDASH 71.5→34.8) and elbow function increased (MEPS 38.3→84.4), with 83% rated good/excellent at follow-up. Autonomy improved (FIM 83.9→114.3). SF-12 physical and mental scores increased (32.5→46.6; 29.6→53.1). Despite these gains, 10 patients (27.8%) did not return to their previous job due to persistent functional limitations.

Conclusion:

Elbow arthrolysis combined with structured inpatient rehabilitation is associated with substantial improvements in pain, function, autonomy and quality of life. However, persistent participation restrictions remain common, with nearly one-third unable to resume their prior occupation. These findings support incorporating vocational planning and targeted participation-focused rehabilitation outcomes when evaluating post-arthrolysis success.