Elbow stiffness was defined as all loss of motion with a limitation in extension greater than 30° and a flexion less than 120°. The etiology is mainly divided into two types. The intra-articular factors mainly include post-traumatic arthritis and joint adversarial hyperplastic synovitis, and the extra-articular factors mainly include ectopically ossified joint capsule contracture and tendon contracture. It is reported that the incidence of elbow movement limitation and stiffness was up to 5% after the elbow trauma or surgery, and 12% of the elbow stiffness caused by injuries around the elbow joint. Compared with the traditional open arthrolysis, arthroscopic arthrolysis had smaller incision, less bleeding, and less postoperative pain, which were conducive to early recovery. For the patients with elbow stiffness caused by intra-articular factors, arthroscopic surgery should be considered if the range of motion was not fully improved or continuously impaired after 6 to 10 months of conservative treatment. Tranexamic acid is an antifibrinolytic drug. In recent years, tranexamic acid had been widely used in orthopaedic surgery, such as total knee replacement, total hip replacement, spine surgery, etc. It had been proved to have good efficacy and safety in reducing postoperative bleeding. In arthroscopic meniscus resection and anterior cruciate ligament reconstruction, the use of tranexamic acid reduced postoperative knee joint hemorrhage, swelling and early postoperative pain. At present, there is a lack of literature on the efficacy of topical tranexamic acid after arthroscopic treatment of elbow stiffness.

To observe the effect of topical application of tranexamic acid (TXA) on arthroscopic elbow arthrolysis.

From March 2018 to February 2020, 61 patients with elbow stiffness underwent arthroscopic elbow arthrolysis. They were divided into group A and B according to the admission time and whether use TXA or not. Patients in group A underwent surgery without TXA from March 2018 to February 2019, while those in group B underwent surgery with TXA from March 2019 to February 2020. The drainage volume, VAS score, elbow range of motion and Mayo elbow function score were compared between two groups.

The postoperative drainage volumes on day 1, day 2 and the total drainage volume in group B were all less than those in group A. The postoperative total drainage volume in group B was (45±35) ml, while it was (109±76) ml in group A, and the difference was statistically significant (P<0.05) . The postoperative elbow range of motion (ROM) was significantly improved in both groups. The loss of postoperative ROM in group B was less than that in group A (7°±9° in Group B vs. 15°±14° in group A, P < 0.05) at the last follow-up, and the difference was statistically significant.

Topical application of tranexamic acid was effective on patients who underwent arthroscopic elbow arthrolysis in reducing the postoperative drainage volume, the early postoperative pain and the loss of postoperative ROM, and it was beneficial to the postoperative functional rehabilitation.