Arthroscopic treatment successfully treats posterior elbow impingement in an athletic population

Abstract

Purpose: Posterior elbow impingement can cause disabling pain and limited motion during activities involving elbow extension. Less understood is whether arthroscopic treatment, compared to open surgery, can result in effective management of pain, loss of range of motion, and return athletes to previous levels of activity. This study determined whether arthroscopic debridement is a safe and effective treatment for posterior elbow impingement and whether it enables athletes to return to a previous level of function.

Methods: A retrospective review of 36 consecutive patients that underwent arthroscopic debridement of the posterior elbow was performed. There were 34 male and 2 female patients, with a median age of 32 years (17-54 years). There were 7 professional athletes, 6 college athletes, and 23 high school or recreational athletes. All patients had a positive posterior impingement test for posterior pain with extension and limitations of activity. Arthroscopic debridement and additional surgical procedures were performed, and patients underwent follow-up visits at a median 51 months (range 14-81).

Results: Significant improvements were seen in pain, motion, and function. No neurovascular complications were seen related to the arthroscopic debridement. The mean Andrews and Timmerman elbow score improved from 159 ± 27 to 193 ± 11 (p < 0.01). Thirty-five of thirty-six (97%) patients returned to their previous level of activity, including all professional athletes.

Conclusions: Arthroscopic management of posterior elbow impingement is safe and effective and can return patients, including professional athletes, to high-level athletic activity. Athletes with symptomatic posterior elbow impingement can be successfully and safely treated with arthroscopic debridement and typically will return to preinjury levels of activity.

Level of evidence: IV.

Keywords: Arthroscopic; Athletes; Debridement; Elbow; Impingement.

Fig. 1

Preoperative radiographs with a circle demonstrating the olecranon osteophyte. a The preoperative AP radiograph showing posteromedial olecranon osteophytes. b The preoperative lateral radiograph showing posterior olecranon osteophytes

Fig. 2

Photographs show arthroscopic views of a a posterior olecranon osteophytes with the osteophyte labelled by an arrow b posterior osteophyte after debridement

Fig. 3

Graph shows Timmerman and Andrews subjective and objective score outcomes