title: Elbow arthroscopy: early complications and associated risk factors.
abstract: BACKGROUND
  Elbow arthroscopy is increasingly used to treat complex pathology. The purpose of this study was to investigate early complication rates after elbow arthroscopy and identify risk factors for adverse events.
  
  
  METHODS
  Consecutive elbow arthroscopies performed during a 13-year period were reviewed, identifying early perioperative complications. Major complications included deep infection, permanent nerve injury, or complications requiring additional anesthesia. Minor complications included superficial wound complications and transient nerve palsies. Complications were compared with a surgical complexity scale based on the procedure performed, the number of arthroscopic portals, and tourniquet time.
  
  
  RESULTS
  Of 417 procedures, there were 37 minor (8.9%) and 20 major (4.8%) complications. The rates of superficial and deep infections were 6.7% and 2.2%, respectively. Major complications included 9 deep infections, 6 cases of heterotopic ossification requiring further surgery, and 4 manipulations under anesthesia. There were 7 transient sensory nerve complications, and no motor deficits. No differences in complication rates were seen between low-, moderate-, and high-complexity (10.2%, 16.3% and 14.4%, respectively) cases. Intraoperative steroid injections were strongly associated with postoperative superficial (14.1% vs 2.0%) and deep infection (4.9% vs 0.4%) in elbows receiving vs those not receiving steroid (P < .0001).
  
  
  CONCLUSIONS
  Complications of elbow arthroscopy are seen in approximately 14% of cases. Most complications are minor, not affecting clinical outcome. Major complications occur in 5% of cases, often requiring repeat surgery. Intraoperative postsurgical steroid injections are associated with increased risk of perioperative infections. Case complexity does not appear to affect the rate of complications with modern surgical techniques.
authors: Shoulder and Elbow Service, Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA.
authors: Gregory N
authors: GN
authors: Nelson
authors: Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
authors: Tiffany
authors: T
authors: Wu
authors: Shoulder and Elbow Service, Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA.
authors: Leesa M
authors: LM
authors: Galatz
authors: Shoulder and Elbow Service, Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA.
authors: Ken
authors: K
authors: Yamaguchi
authors: Shoulder and Elbow Service, Department of Orthopaedic Surgery, Washington University, St. Louis, MO, USA. Electronic address: keenerj@wudosis.wustl.edu.
authors: Jay D
authors: JD
authors: Keener
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000009:adverse effects*; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Case Series; Elbow; Level IV; Treatment Study; arthroscopy; complications; infection