Elbow arthroscopy - Indications and technique

Abstract

Throughout the years, elbow arthroscopy has advanced tremendously due to improvements in technology and surgical techniques. It is now considered a safe and effective treatment for a variety of elbow disorders. Due to the small working space and nearby neurovascular structures, it is a technically challenging procedure. It can be used to successfully treat complaints caused by loose bodies, osteoarthritis, arthrofibrosis, OCD, lateral epicondylitis, VEOS and fractures. The most devastating complication of elbow arthroscopy is (permanent) nerve injury. Therefore, distortion of the anatomy of the elbow joint and transposition of the ulnar nerve can be a contra-indication for elbow arthroscopy due to the higher risk of postoperative complications. The results of the arthroscopy depend on the experience, knowledge, technique and expertise of the performing surgeon.

Elbow Arthroscopy

“…Radicular symptoms originating from the elbow may suggest nerve compression (cubital tunnel syndrome, radial tunnel syndrome, or flexor pronator syndrome). Specific history questions should also inquire about patient occupation (e.g., manual laborer) and sports activities (e.g., weight lifter, thrower, gymnast) [1][2][3][4][5] .…”

“…An incompetent lateral UCL may be assessed with a pivot shift maneuver of the elbow or a push-up from a seated position in an armed chair. These tests may reproduce subluxation of the radial head that is both visible and palpable [1][2][3][4][5] .…”

“…Less common but significant posterior findings include olecranon stress fractures and posterior impingement/ valgus overload syndrome as seen in throwers. Periarticular fractures, loose bodies, arthritis, and elbow dislocations are generally not zone-specific but should always be in the differential diagnosis [1][2][3][4][5] .…”

“…However, arthroscopically assisted radial head fracture management has been reported 9 . Ligamentous repairs/ reconstructions are generally performed in an open fashion; however, arthroscopic evaluation and management of associated loose bodies, osteophyte excision, and debridement/ synovectomy are sometimes concurrently performed at the time of repair/ reconstruction [1][2][3][4][5] .…”

Preoperative Evaluation and Surgical Simulation for Osteochondritis Dissecans of the Elbow Using Three-Dimensional MRI-CT Image Fusion Images

“…A recent study by Pu et al concluded that a combination of radiography, computed tomography (CT), and magnetic resonance imaging (MRI) can most accurately determine OCD lesion stability by compensating for the respective flaws of the individual modalities [ 18 ]. However, at present, surgery is the only means of conclusively confirming the severity of OCD lesions using the classification proposed by the International Cartilage Repair Society (ICRS) [ 19 , 20 , 21 , 22 , 23 ].…”