Restricted mobility of the elbow can be caused by extrinsic or intrinsic causes.

The indication for elbow arthrolysis is made after conservative therapy has been exhausted without any improvement in the findings, usually after 6–12 months. In the case of severe movement restrictions with a global movement amplitude of < 60° and extrinsic causes, e.g., heterotopic ossifications, open arthrolysis is preferable to arthroscopic.

In open arthrolysis, access is most commonly lateral, but can or must be medial, bilateral, or posterior, depending on the cause or existing access.

Open elbow arthrolysis via a lateral approach achieves good results with low complication rates in the case of extrinsic causes. Significantly worse results are recorded for intrinsic causes. Posttraumatic elbow stiffness shows significantly better postoperative outcomes in terms of range of motion gain when compared to degenerative elbow stiffness.

Open elbow arthrolysis is still a frequently used procedure for the treatment of elbow stiffness and is particularly suitable for posttraumatic, extrinsic pathologies.