Extra-articular arthroscopic lateral elbow release.
We describe a unique extra-articular approach for arthroscopic lateral release for lateral epicondylitis. An arthroscopic extra-articular approach allows better direct visualization of diseased structures with a 30 degrees arthroscope and only requires a small hole in the joint capsule. The camera is placed into the joint through the middle anterolateral portal. The camera is then pulled back through a small rent in the capsule over the lateral radiocapitellar joint to provide an extra-articular view of the diseased structures. The shaver is then placed 1.5 cm proximal to the camera in a proximal anterolateral portal. Debridement of the common extensor fiber tendinosis and decortication of the lateral epicondyle are performed under direct visualization. This is different from the intra-articular technique, where visualization with the 30 degrees arthroscope is more difficult despite a large capsulotomy to aid visualization. The advantage of this extra-articular technique is 2-fold. First, the extra-articular viewing portal allows direct visualization of diseased structures, improving accuracy for debridement compared with an intra-articular viewing portal. The intra-articular technique uses the 30 degrees arthroscope to work around a corner after a large capsulectomy. The second advantage of the extra-articular viewing portal is that it only requires a small capsulotomy. The small capsulotomy decreases the risk of transient radial nerve palsy associated with a capsulectomy. The small capsulotomy also results in less fluid extravasation into the soft tissues. Less fluid extravasation decreases swelling and the risk of compartment syndrome.
Brooks-Hill
Alexandra L
AL
Department of Athletic Injuries and Arthroscopy, Sea to Sky Orthopaedics, Squamish General Hospital, Squamish, British Columbia, Canada.
Regan
William D
WD
D001182:Arthroscopy / Q000379:methods*; D006801:Humans; D017746:Joint Capsule / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012680:Sensitivity and Specificity; D000074402:Synovectomy; D013583:Synovial Membrane / Q000503:physiopathology; D013673:Technology Assessment, Biomedical; D013710:Tendons / Q000503:physiopathology / Q000601:surgery*; D013716:Tennis Elbow / Q000601:surgery*