Arthroscopic elbow surgery, is it safe?

Abstract

Background: During the past 10 years, the use of arthroscopic elbow surgery has increased tremendously. The proximity of neurovascular structures and narrow joint spaces make it a technically demanding procedure with many potential complications. The purpose of this study was to report the complications in a large series of patients and identify factors that might have contributed to their occurrence.

Materials and methods: During an 8-year period, 200 elbow arthroscopies were performed by a single surgeon. All procedures were performed in a standardized fashion. Patient records were reviewed by independent observers. The minimum follow-up for all patients was 8 weeks.

Results: The only major permanent complication (0.5%) identified was an ulnar nerve injury. Minor complications were identified in 14 patients (7%): 3 transient nerve palsies, 4 prolonged serous drainages or superficial wound infections, 6 persistent elbow contractures, and 1 mild increase in contracture. Of reported patients with complications, 9 (60%) had a history of trauma, fracture, or previous surgery. In 11 patients with direct surgery-related complications, 8 (73%) had a similar history.

Conclusion: The complications encountered in our series are well within the limits of earlier reports and show that with only a 0.5% rate of major complications, elbow arthroscopy is a relatively safe procedure for a wide variety of indications when performed in a standardized fashion. In patients with a history of trauma or previous surgery, the procedure is more challenging and, in less experienced hands, might lead to higher complication rates.