Review of Poehling et al (1989) on elbow arthroscopy: a new technique

Abstract

This classic discusses the original publication ‘Elbow Arthroscopy: A New Technique’ by Poehling et al, published in 1989 in The Journal of Arthroscopic and Related Surgery on the introduction of the prone position and the proximal medial portal to elbow arthroscopy. The first attempt to perform elbow arthroscopy was on a cadaveric specimen by Burman in 1931, after which it took approximately 50 years until the first reports on the successful clinical use of elbow arthroscopy were published. By then patients were commonly placed in the supine(-suspended) position, wherein access to the posterior compartment was somewhat difficult, and entry to the anterior compartment of the elbow was commonly established using anteromedial and anterolateral portals, which were increasingly associated with nerve injury. In 1989, Poehling et al published on the successful clinical use of two new techniques: the prone position and the proximal medial portal. The proximal medial portal meant a first established safe and reproducible entry into the anterior compartment of the elbow that is still commonly used today. With these techniques, Poehling et al improved visualisation of the elbow joint and showed that elbow arthroscopy could be performed safely and reliably despite the closeness of neurovascular structures, transitioning elbow arthroscopy from being pioneer work into a safe surgical procedure that would become part of the common orthopaedic practice. This classic places the work of Poehling et al in a historic perspective, discusses its impact at the time and relates it to scientific developments up to the present day.

Force measurement metrics for simulated elbow arthroscopy training

“…Over the past decades elbow arthroscopy has become a surgical tool due to better understanding of the neurovascular anatomy, technical advancements, and broadening range of indications (Hilgersom et al, 2018 ; Yeoh et al, 2012 ). An increase in elbow arthroscopy use is expected to raise the number of complications, which emphasizes the importance of training in portal placement and arthroscopic skills to deliver safe surgical care (Rose & Pedowitz, 2015 ).…”