Only one study directly compared open versus arthroscopic elbow contracture release in the setting of ostoarthritis; outcomes and complication rates are comparable and both procedures can yield reliable improvements in elbow range of motion [52]. Likewise, when examining the literature with respect to open and arthroscopic releases, the outcomes appear to be similar [53–58].

While elbow arthroscopy has been utilized for a variety of clinical problems, it remains a technically challenging procedure with the potential for serious complications given the proximity of important neurovascular structures. Injury to each of the susceptible peripheral nerves about the elbow has been reported following elbow arthroscopy; injury is probably under-reported. In addition, certain diagnoses or conditions confer what appears to be an increased risk with this procedure. In a series from the Mayo Clinic, transient nerve palsies were noted in 12 of 473 elbow arthroscopies [16]. Statistically significant factors associated with injury included diagnosis of contracture and performing a capsular release [16]. Posttraumatic contractures are also subject to distortion of bony and or soft tissue landmarks, which may make neurovascular structures more vulnerable to injury [38]. Compartment syndrome has been shown to be an infrequent, albeit devastating complication of the procedure [59]. Kim et al. [60] studied the learning curve for arthroscopic treatment for limitation of elbow range of motion and found a statistically significant decrease in operative time after the initial 15 patients and that operative time was negatively correlated with range of motion. Interestingly, increasing surgeon experience did not correlate with postoperative motion and clinical outcomes; the authors theorize that this is related to the influence of “case mix,” or the tendency for a surgeon to treat more difficult cases as they become more proficient [60].