title: Elbow arthroscopy: An alternative to anteromedial portals.
abstract: BACKGROUND
  Elbow arthroscopy is considered to be a difficult procedure with a high complication rate. These two disadvantages are due to the proximity of neurovascular structures.
  
  
  OBJECTIVE
  The aim of our study was to evaluate the efficacy and complication rate of a new elbow arthroscopy technique without anteromedial portals. This approach was taken because of the high rate of ulnar nerve damage using the medial portal, and the difficulty of performing triangulation of opposite portals in a patient in the lateral decubitus position.
  
  
  METHODS
  Fifteen patients were operated on by the same surgeon between 2010 and 2012. Range of motion and the "MEPS" elbow score were calculated preoperatively and at the final postoperative follow-up. The average age of patients was 38.3 years. The follow-up was 11.1 months. Personal portals (high anterolateral and intermediate anterolateral portals) were used instead of the anteromedial portals.
  
  
  RESULTS
  Elbow flexion increased from 113° preoperatively to 129° at the final follow-up (P=0.009). Extension increased from -33° to -10° (P<0.0001). The preoperative and final postoperative "MEPS" scores were 56.3 and 94 respectively (P<0.0001). Two patients (13.3%) had radial nerve palsy with complete recovery 6 and 9 months after surgery.
  
  
  CONCLUSIONS
  The rate of nerve complications following elbow arthroscopy varies from 0 to 14%. The rate in our series (13.3%) is comparable to the results of the literature. This rate should be placed in perspective (since one patient had multiple open surgery elbow operations before arthroscopy). All complications were transient. Improved elbow range of motion in our study is consistent with the results in literature.
authors.affiliation: Service de chirurgie orthopédique, hôpital Cochin, 47-83, boulervard de l'Hôpital, 75013 Paris, France. Electronic address: firass_elhajj@hotmail.com.
authors.forename: F
authors.initials: F
authors.lastname: El Hajj
authors.affiliation: Faculté de santé publique, université libanaise, Hadath, Lebanon.
authors.forename: M
authors.initials: M
authors.lastname: Hoteit
authors.affiliation: Service de chirurgie orthopédique, hôpital Cochin, 47-83, boulervard de l'Hôpital, 75013 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Ouaknine
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007592:Joint Diseases / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D055815:Young Adult
keywords: Arthroscopy; Complications; Elbow; Portals