Publication: Clinical guideline on the open arthrolysis for post-traumatic elbow stiffness in adult patients
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Issued Date
2025-01-01
Resource Type
ISSN
10582746
eISSN
15326500
Scopus ID
2-s2.0-105018522574
Pubmed ID
40865905
Journal Title
Journal of Shoulder and Elbow Surgery
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Shoulder and Elbow Surgery (2025)
Suggested Citation
Sun Z., Li J., Van Riet R., Ho P.C., Hildebrand K.A., Puah K.L., Shih J.T., Li Z., Chanlalit C., Kekatpure A.L., Zhang K., Liu S., Gong M., Huang F., Yan H., Mi J., Lu J., Zha Y., Xiang Z., Xiang M., Li F., Jiang S., Liu W., Zhong B., Ding J., Ruan H., Ouyang Y., Wang W., Yu S., Chen S., Qian Y., Xu Y., Hu Y., Xu J., Jiang X., Jeon I.H., Fan C. Clinical guideline on the open arthrolysis for post-traumatic elbow stiffness in adult patients. Journal of Shoulder and Elbow Surgery (2025). doi:10.1016/j.jse.2025.07.015 Retrieved from: https://hdl.handle.net/20.500.14740/50624
Author(s)
Sun Z.
Li J.
Van Riet R.
Ho P.C.
Hildebrand K.A.
Puah K.L.
Shih J.T.
Li Z.
Chanlalit C.
Kekatpure A.L.
Zhang K.
Liu S.
Gong M.
Huang F.
Yan H.
Mi J.
Lu J.
Zha Y.
Xiang Z.
Xiang M.
Li F.
Jiang S.
Liu W.
Zhong B.
Ding J.
Ruan H.
Ouyang Y.
Wang W.
Yu S.
Chen S.
Qian Y.
Xu Y.
Hu Y.
Xu J.
Jiang X.
Jeon I.H.
Fan C.
Li J.
Van Riet R.
Ho P.C.
Hildebrand K.A.
Puah K.L.
Shih J.T.
Li Z.
Chanlalit C.
Kekatpure A.L.
Zhang K.
Liu S.
Gong M.
Huang F.
Yan H.
Mi J.
Lu J.
Zha Y.
Xiang Z.
Xiang M.
Li F.
Jiang S.
Liu W.
Zhong B.
Ding J.
Ruan H.
Ouyang Y.
Wang W.
Yu S.
Chen S.
Qian Y.
Xu Y.
Hu Y.
Xu J.
Jiang X.
Jeon I.H.
Fan C.
Author's Affiliation
Fudan University
Xi'an Jiaotong University
Nanjing University
University of Calgary
West China School of Medicine/West China Hospital of Sichuan University
Wake Forest University School of Medicine
University of Ulsan College of Medicine
Shandong First Medical University & Shandong Academy of Medical Sciences
Prince of Wales Hospital Hong Kong
Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine
Singapore General Hospital
Shanghai Sixth People's Hospital
The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University
Beijing Jishuitan Hospital
Peking University Shenzhen Hospital
Taoyuan Armed Forces General Hospital
Wuxi Ninth People's Hospital
Faculty of Medicine, Srinakharinwirot University
AZ Monica
Harley Street Specialist Hospital
Sichuan Provincial Orthopedic Hospital
DMIHER’S DMMC
Xi'an Jiaotong University
Nanjing University
University of Calgary
West China School of Medicine/West China Hospital of Sichuan University
Wake Forest University School of Medicine
University of Ulsan College of Medicine
Shandong First Medical University & Shandong Academy of Medical Sciences
Prince of Wales Hospital Hong Kong
Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine
Singapore General Hospital
Shanghai Sixth People's Hospital
The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University
Beijing Jishuitan Hospital
Peking University Shenzhen Hospital
Taoyuan Armed Forces General Hospital
Wuxi Ninth People's Hospital
Faculty of Medicine, Srinakharinwirot University
AZ Monica
Harley Street Specialist Hospital
Sichuan Provincial Orthopedic Hospital
DMIHER’S DMMC
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Post-traumatic elbow stiffness poses significant clinical challenges for upper limb surgeons and severely impairs patients’ ability to perform essential daily activities, including eating, dressing, and personal hygiene, thereby imposing substantial socioeconomic burdens. Open arthrolysis is widely employed when conservative therapies fail, yet current literatures demonstrate considerable heterogeneity in treatment concepts, surgical techniques, and perioperative management. This evidence-based clinical practice guideline aims to standardize treatment profiles and improve surgical outcomes for open arthrolysis of post-traumatic elbow stiffness in adult patients globally. Methods: The Chinese National Center for Orthopaedics (Shanghai and Beijing, China) and Asan Medical Center (Seoul, Korea) initiate, sponsor, and organize a collaboration among worldwide experts in the field of elbow to develop this guideline, adhering to the Reporting Items for Practice Guidelines in Healthcare. Evidence searches focus on meta-analyses, systematic reviews, randomized controlled trials, cohort studies, case-control studies, and case series studies. The Grading of Recommendations Assessment, Development and Evaluation system and Delphi method process are used to assess the level of evidence and strength of recommendations. Results: Finally, a total of 28 evidence-based recommendations for open arthrolysis in adult post-traumatic elbow stiffness are formulated in response to 13 most concerned important clinical questions. On the whole, recommendations span 4 domains: (1) Indications/Timing; Q1-Q2, 2 recommendations; (2) Surgical Techniques; Q3-Q8, 15 recommendations; (3) Perioperative Care; Q9-Q11, 8 recommendations; and (4) Complication Prevention; Q12-Q13, 3 recommendations. Conclusion: This multinational initiative provides the first comprehensive clinical practice guideline for open arthrolysis in adult post-traumatic elbow stiffness. The recommendations provided herein are grounded in a comprehensive review of existing literatures, and they establish actionable standards for preoperative decision-making, intraoperative techniques, and postoperative care, ultimately hoping to enhance patients’ functional recovery and quality of life.