Elbow Arthrolysis Rehabilitation Protocol

Elbow Arthrolysis Rehabilitation Protocol

This protocol outlines the post-operative management and rehabilitation following elbow arthrolysis, a surgical procedure aimed at improving restricted range of motion (ROM) in the elbow joint. The primary goals are to restore motion, reduce pain and swelling, and gradually regain strength and function.

Surgical Overview

Elbow arthrolysis involves the release of the joint capsule, removal of osteophytes, and potentially the inspection and treatment of the ulnar nerve. The surgery addresses both anterior and posterior adhesions to improve elbow flexion and extension.

Contraindications

• None: There are no contraindications specific to this procedure.

Rehabilitation Phases

Inpatient Phase

Goals:

1. Document Progress: Record the intra-operative ROM achieved (if available from operation notes).
2. Swelling and Pain Management: Use ice and elevation as appropriate.
3. Maintain Adjacent Joint Mobility: Begin exercises for the scapula, neck, shoulder, wrist, and hand.
4. Initiate Elbow Exercises:
   • Start with active-assisted exercises progressing to active ROM for flexion, extension, pronation, and supination.
   • Emphasize the importance of regular exercise.
5. Encourage Functional Use: Advise light arm and hand activities with no lifting.
6. Brace Application: Provide a Mayo brace for nighttime use (extension/flexion adjusted based on pre-op deformity) for 3 months, with gradual position adjustments.

Discharge Instructions:

• Reinforce the importance of regular elbow exercises.
• Refer to physiotherapy outpatient services ideally within 1 week.

Outpatient Phase

Goals:

1. Restore ROM and Strength:
   • Gradually increase ROM as tolerated.
   • Begin strengthening exercises as comfort allows.
   • Progress to rhythmic stabilisation exercises.
2. Encourage Functional Use:
   • Light arm and hand activities without lifting.

Progression:

• Continuously monitor ROM and strength improvements.
• Address any pain or discomfort during exercises.

Return to Activities

• Light Duties: Resume at 4 weeks post-op.
• Heavy Duties: Resume at 6 weeks, based on individual progress and comfort.

Additional Notes

• Patients should adhere to the prescribed exercise regimen to optimise outcomes.
• Regular follow-up with a physiotherapist will ensure proper progression and address any issues.

For further assistance, contact the Physiotherapy team or the Consultant Secretary:

• Sulis Hospital Physiotherapy: 01761 422388
• Circle Health Group Bath Clinic Physiotherapy: 01225 838767
• St. Joseph Physiotherapy: 01633 820321

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