Supine Elbow Arthroscopy: A decade of results with a vertical humerus and a free forearm

Abstract

Background Elbow arthroscopy has been in existence for decades, but to date little innovation in elbow positioning for arthroscopy has occurred. After experiencing disadvantages with lateral decubitus, prone, and supine suspended positioning techniques, the author has changed to a supine positioning technique that stabilizes the humerus vertically while leaving the forearm free for all elbow arthroscopy procedures. Methods A retrospective review was conducted for arthroscopic elbow surgeries performed by a single surgeon in a single surgery center in the supine elbow arthroscopy (SEA) position from 2011 to 2021. Efficiency, safety, and versatility of elbow arthroscopy performed in the SEA position were analyzed. Results In 298 relevant arthroscopic surgical procedures performed on 289 patients, the average total procedural time was 52.2 minutes, with an average arthroscopic (surgical) time of 31.2 minutes. No complications were found in the review of medical records. Conclusions SEA promotes safe, technically easier, and more efficient elbow arthroscopy with improved surgical access, intraoperative flexibility, and accelerated procedural times compared with other current techniques.

Approaching the Humerus, Elbow, and Proximal Forearm Using the Trimano Arm Holder

“…Additionally, the manufacturer's method prevents access to the humerus due to the attachment's placement at the midhumerus level. Hunter [6] previously described supine elbow arthroscopy using a static arm holder, but in that technique, the forearm is held with a static positioner which is applied on the operative side of the patient. Chen et al described a different technique of supine elbow arthroscopy with an articulating arm holder placed on the operative side in proximity to the surgical team [7].…”