A method for treating patients with elbow joint contractures using hydraulic mobilization

Introduction Restricted elbow function following injury and disease results in pathophysiological changes in the muscles, tendons, joint capsule, and cartilage. Intra-articular fibrous adhesions and arthrofibrosis with collagen deposition and synovial hypertrophy develop. It aggravates the contracture and complicates treatment.

The purpose of the work was to present a new method of treating patients with elbow joint contractures using hydraulic mobilization that eliminates bone conflict during flexion-extension movements.

Materials and Methods To improve the effectiveness of treatment for patients with flexion and flexionextension contractures of the elbow joint without bony conflicts during articular surface movements, a method of hydraulic mobilization was developed (Invention Application No. 2025131920 dated November 14, 2025). The method includes sequential hydraulic lavage, hydraulic mobilization of the dorsal and ventral sections of the elbow joint, medication administration, and staged plaster casting. This method was used to treat a 63-year-old patient with post-traumatic contracture and osteoarthritis of the right elbow joint. Elbow flexion was 40°, extension 90°. At short- and long-term (one year) follow-ups after surgery, the patient's quality of life significantly improved: self-service was full, pain was absent, and elbow movements were restored.

Discussion Methods for administering fluids under pressure for joint dilation in shoulder and knee pathologies, arthroscopic debridement with continuous passive motion and intra-articular analgesic infusion, and hydraulic lavage of the elbow joint for osteoarthritis are known. However, continuous passive motion can lead to soft tissue trauma and microtears of muscle fibers, resulting in pain and secondary contracture. The developed method has advantages: it allows for the separation of fibrous adhesions thereby the effectiveness of treatment depends on the consistent performance of surgical and postoperative procedures to prevent contracture recurrence

Conclusion The proposed method of hydraulic mobilization for treatment of patients with elbow joint contractures caused by fibrotic changes in the tissues is a low traumatic, minimally invasive surgical intervention that improves the effectiveness of restoring joint function when the indications for its use are met.

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