Upper-limb surgery · UK
Elbow arthrolysis — giving a stiff elbow its arc back.
A proper release of a stiff elbow by a consultant upper-limb surgeon — arthroscopic where it fits, open where it does not, with the ulnar nerve and heterotopic bone dealt with at the same sitting, and physio that starts inside 72 hours.
Why patients choose us
- 01
A consultant elbow surgeon, in theatre
Not a general orthopaedic list. A named upper-limb surgeon who does stiff elbows regularly, in a proper theatre with an anaesthetist.
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Arthroscopic when it fits, open when it does not
Arthroscopic release for the right elbow; open column procedure when the block is bony or heterotopic ossification is heavy. We tell you which, and why.
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Independent, and free
We are paid by no clinic, so the recommendation on surgery, physio and timing is impartial and costs you nothing.
Indicative pricing
What private elbow arthrolysis costs in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three surgeons.
In short
Arthroscopic release in our network: £6,500–£9,500, home next day.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Arthroscopic elbow arthrolysis | £6,500–£9,500 | 60–90 min | Day case / 1 night |
| Open elbow arthrolysis (column procedure) | £8,000–£12,500 | 90–120 min | 1–2 nights |
| Arthrolysis + ulnar nerve decompression | £8,500–£13,000 | 90–120 min | 1–2 nights |
| Arthrolysis + HO excision | £9,500–£14,000 | 2 hours | 1–2 nights |
| Consultant clinic review + imaging | £350–£700 | 45 min | Same visit |
| Post-op physiotherapy (per session) | £75–£140 | 45 min | 2–3× per week |
Prices vary by surgeon, by whether the release is arthroscopic or open, by whether the ulnar nerve is transposed, and by the amount of heterotopic bone that needs excising. We come back with a firm quote within one working day.
The problem
The right surgeon, the right approach, the right physio — from day one.
A stiff elbow is one of the least forgiving operations in orthopaedics. Get the surgeon, the technique or the post-op physio wrong and the arc goes back to where it started within weeks.
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Not sure surgery is the answer?
Physio, splints and injections come first for many stiff elbows. We say so before you agree to a release.
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Worried about the ulnar nerve?
A surgeon who does stiff elbows weekly will decompress or transpose the nerve when it needs it — not as an afterthought.
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Want the gains to hold?
CPM in recovery, physio inside 72 hours, and a plan that runs for three to six months — not a discharge letter and good luck.
The journey
From enquiry to a working arc — what happens, in order.
One clinician from first message to review — including the physio window that decides the result.
Phase 1 · Before surgery
Concierge, off-stage for you
Phase 2 · On the day
A few hours in theatre
Phase 3 · After
Physio and review
- 01
Before
You tell us what is going on
A short, confidential form. How the elbow got stiff, how much motion you have lost, whether it is the dominant arm.
- 02
Before
We come back with a recommendation
Within one working day: the right surgeon, whether an arthroscopic or open release is more likely, and an indicative price.
- 03
Before
Imaging and clinic review
X-rays, and usually a CT for bone spurs or heterotopic ossification. MRI is added if the capsule or ulnar nerve needs looking at.
- 04
On the day
Arrival at the clinic
Arrival, consent, block or GA with an anaesthetist. Most elbow releases are done under general anaesthetic with a regional nerve block for pain.
- 05
On the day
The procedure itself
60 to 120 minutes. Capsular release, removal of osteophytes and loose bodies, and ulnar nerve decompression or transposition when indicated.
- 06
On the day
Overnight, or home the same day
Many patients stay one night for pain control and to start continuous passive motion (CPM) in the first 24 hours.
- 07
After
Aggressive early physio
Physiotherapy inside 72 hours is the point of the operation. Full recovery of the working arc takes three to six months.
Typical end-to-end: 2–3 weeks from enquiry to surgery. Functional arc: 3–6 months.
When it helps
When elbow arthrolysis is the right step.
The situations we see most, and the nerve red flag that means an appointment this week, not next month.
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Post-traumatic stiffness
The commonest cause. A stiff elbow after a fracture, dislocation or terrible-triad injury that never regained its arc.
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Arthrofibrosis
Dense capsular scarring after injury or previous surgery — the capsule contracts and blocks both flexion and extension.
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Heterotopic ossification (HO)
Bone forming in the soft tissues after head injury, burns, or elbow trauma — often needs excision as well as release.
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Primary elbow arthritis
Osteophytes at the tip of the olecranon and coronoid that mechanically block the last 20–30° of extension and flexion.
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Chronic dislocation
A long-standing dislocation or subluxation that has left the elbow stiff, unstable, and functionally poor.
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Post-burn contracture
Skin and capsular contracture after burns, especially across the front of the elbow.
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Arc under 100° affecting daily life
If the working arc is under 100° or extension is worse than 30°, dressing, eating and grooming become genuinely hard.
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Red flag: sudden ulnar nerve signs
New numbness, weakness or wasting in the little and ring fingers is not something to sit on — get seen this week, not next month.
Procedure options
Not every stiff elbow is released the same way.
What each option on the table actually involves — and which fits which cause of stiffness.
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Arthroscopic release
Keyhole capsular release, removal of osteophytes and loose bodies. Best for moderate stiffness without heavy HO or severe deformity.
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Open column procedure
A lateral (Kocher) approach releases the anterior and posterior capsule around the column of the humerus while protecting the medial ligament.
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Medial column-safe release
A limited release when the ulnar nerve is the priority — decompressed or transposed at the same sitting.
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Combined open release
Both a lateral and a medial approach when the block is circumferential — for heavy HO or long-standing arthrofibrosis.
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HO excision + prophylaxis
Ectopic bone is excised and recurrence is reduced with a short course of indomethacin, or single-dose radiotherapy in higher-risk cases.
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Ulnar nerve decompression / transposition
Added when the nerve is symptomatic or at risk after regaining flexion — needed in up to one in five cases.
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Interval-guided release
Selective release of only the tight interval (anterior for extension loss, posterior for flexion loss) to preserve stability.
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Consultation only
An honest discussion of whether release is likely to give you the arc back — or whether physio and injections should come first.
Our vetted UK network
A small panel of upper-limb surgeons, we picked them.
Consultant upper-limb surgeons across London, Birmingham, Manchester and Leeds. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every surgeon in our network.
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Consultant upper-limb surgeons with a stiff-elbow practice, not general orthopaedic lists
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Access to CT and MRI in one visit for pre-operative planning
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On-site physiotherapy able to start within 72 hours of surgery
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Regional anaesthesia and CPM protocols available as standard
Safety and recovery
What to expect afterwards — honestly.
Elbow arthrolysis is a demanding operation with a demanding rehab. The things to plan are the ulnar nerve, the physio window, and the three-to-six month arc of recovery.
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Ulnar neuropathy is the main risk
Regaining flexion stretches an already tight nerve. Up to 20% of cases need the nerve decompressed or transposed to keep the hand safe.
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Recurrent stiffness is possible
Some elbows scar down again, particularly after head injury or in heavy HO. Aggressive early physio is what keeps the gains.
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Recurrent heterotopic ossification
Indomethacin for two to six weeks, or a single dose of radiotherapy in higher-risk cases, reduces the chance the bone comes back.
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Immediate CPM and physio
Continuous passive motion often starts in recovery. Formal physiotherapy starts within 72 hours — the operation only works if this happens.
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Incomplete gains are honest
A realistic aim is a functional arc — usually ≥100° of flexion-extension and extension to within 30°. Full symmetry with the other side is uncommon.
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Infection and wound issues
Around 1–2% risk. Deep infection is rare but serious in an elbow with implants or graft — spreading redness or fever means same-day review.
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Three to six months to plateau
The arc keeps improving for months, not weeks. Judging the result before three months is unfair to the operation and to you.
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Functional benchmarks
Enough motion to reach the mouth, the top of the head, and the perineum is the practical bar — not a goniometer number.
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Red flags
New hand numbness or weakness, spreading wound redness, fever, or sudden loss of the motion you had gained — call the team the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and starting arc
Why the operation was done — post-traumatic, arthritic, HO — and the pre-operative flexion-extension arc in degrees.
- 02 Technique
Approach, release and nerve handling
Arthroscopic or open, which intervals were released, whether HO was excised, and whether the ulnar nerve was decompressed or transposed.
- 03 Findings
Intra-operative arc achieved
The arc measured on the table at the end of the procedure — this is the ceiling physio will try to hold onto.
- 04 Impression
Physio plan, prophylaxis, review timing
Read this first: CPM settings, when physio starts, whether indomethacin or radiotherapy is used, and when the surgeon will see you again.
Recognised by major UK insurers
Cover for elbow arthrolysis is usually funded when the stiffness is post-traumatic or functionally disabling. We confirm cover, excesses and physio limits before booking.
Frequently asked
Everything we get asked about elbow arthrolysis.
Quick answers on motion gained, arthroscopic vs open, cost, the ulnar nerve, and how much recovery to plan for.
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What is elbow arthrolysis?
A surgical release of a stiff elbow. The tight capsule is cut, any osteophytes or heterotopic bone are removed, and — where needed — the ulnar nerve is freed. It can be done arthroscopically (keyhole) or open, depending on the cause and severity of the stiffness.
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How much motion can I expect to get back?
The realistic aim is a functional arc: at least 100° of flexion-to-extension, with extension to within about 30° of straight. Most patients regain most of the motion demonstrated on the table at the end of the operation, provided physiotherapy starts within 72 hours.
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Arthroscopic or open — which is better?
Neither is universally better. Arthroscopic release suits moderate capsular stiffness without heavy heterotopic ossification. Open release is chosen when the block is bony, when heterotopic ossification is present, or when the ulnar nerve needs decompression or transposition.
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How much does private elbow arthrolysis cost in the UK?
Roughly £6,500–£9,500 for arthroscopic release, £8,000–£12,500 for an open column procedure, and £9,500–£14,000 when heterotopic ossification excision or ulnar nerve transposition is added. Pulse Atlas confirms a firm figure across two or three surgeons within one working day.
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How long is recovery?
You can expect visible swelling for two to three weeks and functional use of the elbow at six to eight weeks. The arc keeps improving for three to six months, and formal review continues over that period.
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Why does physiotherapy start so early?
A released elbow scars quickly. Continuous passive motion and hands-on physio inside 72 hours are what keep the arc you were given in theatre. Delaying by even a week can lose motion that is very hard to get back.
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When should I see someone urgently?
New numbness or weakness in the little and ring fingers, spreading redness, fever, or a sudden loss of motion you had regained — all reasons to contact the surgical team the same day rather than waiting for a scheduled review.
Related treatments
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All tests & procedures
Every test and procedure we arrange.
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