[Arthroscopy of the elbow joint].
OBJECTIVE
The authors evaluate a group of patients who underwent elbow arthroscopy in the period between August 2001 and August 2003. They pay attention to indications, the technique used, surgical diagnoses, postoperative outcomes and complications.


METHODS
We performed 28 elbow arthroscopies in 26 patients; two patients were operated on both elbow joints. The group comprised 20 men and 6 women between 14 to 73 years, with an average of 44 years. The average follow-up was 18 months (range, 4-28 months).


METHODS
We usually operated on patients in a prone position under general anesthesia, with the use of a tourniquet. We used the following approaches: anterolateral and anteromedial, posterolateral (also termed direct lateral approach), posterocentral and upper posterolateral. To evaluate the outcome we used the modified Morrey system for the elbow joint after surgery. We assessed pain and the ability to manage daily activities, joint mobility and the presence of complications.


RESULTS
Of 28 elbows, 21 had excellent outcomes and seven were satisfactory; no poor outcome was recorded. Most of the patients were satisfied with the postoperative result (25 out of 28 arthroscopies; 89%). An improvement by 20 degrees and more was achieved in the range of motion in 14 out of 21 patients (67%). No infection or serious injury to nerves or blood vessels was recorded.


CONCLUSIONS
In elbow arthroscopy, the proximal modifications of anteromedial and anterolateral approaches proved to be more convenient, permitting better manipulation with instruments. The removal of intra-articular bodies was one of the first indications for arthroscopy. Good postoperative outcomes, similar to those reported in the literature, stimulated us to employ elbow arthroscopy also in other indications. With the use of a gentle technique, good results can be achieved in some acute injuries or post-traumatic conditions in which, however, arthroscopy requires greater skills. The same experience has been reported by other authors. We recorded no serious neurovascular complications; these are described to occur at a frequency of 0 to 15%.


CONCLUSIONS
Taking all risks into consideration, elbow arthroscopy is beneficial for patients and is a contribution to elbow surgery. Our results suggest that elbow arthroscopy is the method of choice for not only removal of the intra-articular bodies, but also treatment of moderate arthritis not responding to conservative therapy for 3 to 6 months at least. Elbow arthroscopy may be benefical to co-operation with the rheumatologist and in traumatic conditions. As in arthroscopy for other joint, it has the advantage of a much shorter postoperative morbidity than in open procedures.
Kopecek
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Ortopedické odd. Nemocnice Kyjov. kopecek@nemkyj.cz
D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography