Pain, function, and patient satisfaction after arthroscopic treatment of elbow in a retrospective series with minimum of 5-year follow-up

Abstract

Background: The clinical indications for elbow arthroscopic procedures have expanded through last decades. The aim of the study was to assess the functional results and patient satisfaction after arthroscopic treatment of various elbow conditions after a minimum 5-year follow-up. Methods: We conducted a retrospective study of a consecutive patient cohort who had undergone unilateral elbow arthroscopy between 2008 and 2010. The main outcomes were Disabilities of the Arm, Shoulder and Hand (DASH) score and a specific patient-reported outcome measure questionnaire after a minimum 5-year follow-up. Results: In total, there were 93 patients in the cohort with different diagnoses. Majority of patients were suffering from elbow osteoarthrosis. After the average follow-up of 72 months (range 60–96 months), the response rate was 67%. Eighty two percent of patients were satisfied with the pain relief and locking of the elbow was relieved in 70% of patients. Elbow range of motion (ROM) improved in 80% of the 55 patients who had a limited ROM before the operation. The overall patient satisfaction after elbow arthroscopic treatment was good. There were no differences in median DASH score between patients with or without post-traumatic condition, but the median DASH score for patients who had severe (grade 3) osteoarthrosis before the operation was significantly worse. There were no major complications reported in this cohort. Conclusions: Arthroscopic treatment of various elbow conditions was associated with good patient satisfaction and reduced symptoms without major complications. Level of Evidence: Level IV, therapeutic case series.

Lower nationwide rates of arthroscopic procedures in 2016 compared with 1997 (634925 total arthroscopic procedures): has the tide turned?

“…44 We were unable to identify any randomised controlled trials of the efficacy of elbow arthroscopy. Publications describe clinical outcomes of patient cohorts--such as the series of elbow arthroscopic debridement surgery performed on patients with primary or post-traumatic osteoarthritis, 51 and osteochondritis dissecans and posterior impingement. [52][53][54][55] Only case reports and expert opinions on several elbow pathologies suggest the use of arthroscopic procedures in evaluation and treatment.…”

Surgical management for primary osteoarthritis of the elbow

“…It has been suggested that any functional restoration or symptom relief that can be achieved by open surgery can be fully accomplished by arthroscopy. 34,45,46 A recent study also reported the comparable clinical outcomes associated with arthroscopic OCA with the important finding that neither procedure can guarantee excellent outcomes in patients with advanced osteoarthritis. 47 In a systematic review, Kim et al reported that both open and arthroscopic OCA improve ROM and clinical scores and that open debridement is associated with a relatively higher complication and reoperation rates than arthroscopic OCA.…”

Wide Range in Complication Rates Following Elbow Arthroscopy in Adult and Pediatric Patients: A Systematic Review

“…1,2 Complication rates should be minimalized to avoid reoperations because this significantly impacts patientreported outcome measures. 3 As the use of arthroscopy increases for treating elbow pathology, insight into the incidence and type of complications should help surgeons refine their surgical techniques to reduce the complication rates further. Complications associated with elbow arthroscopy are wound infections, transient or permanent nerve palsies, hematomas, heterotopic ossifications, stiffness, and chronic pain; with some requiring additional surgical intervention.…”