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Arthroscopy of the elbow: a long-term clinical review
A S Reddy1, R S Kvitne, L A Yocum
1Kerlan-Jobe Orthopaedic Clinic and Centinela Hospital, Los Angeles, California, USA. asreddy@ pocatlanta.com
Purpose:
The purpose of this study was to review a large group of patients who had arthroscopy of the elbow to determine the efficacy and relative risks of this procedure.
Type Of Study:
We retrospectively reviewed a convenient sample of 172 patients who underwent 187 arthroscopies of the elbow over a 7-year period.
Materials And Methods:
All patients had their charts and radiographs reviewed, and 104 of these patients were also contacted for a telephone interview at an average follow-up of 42.3 months (range, 7 to 115 months).
Results:
The procedures were performed primarily by 7 different surgeons, using all 3 standard operating positions and a variety of arthroscopic portals. The most common diagnosis was posterior impingement in 96 patients (51%), followed by loose bodies in 72 patients (31%), and degenerative joint disease in 32 patients (22%). The average preoperative modified Figgie score was 27.7 points (range, 17-43) for all patients. The average postoperative score was 45.4 points (range, 29-50), with the largest increase occurring in the pain score. There were 51 patients (56%) with an excellent surgical result, 37 patients (36%) with a good result, 12 patients (11%) with a fair result, and 4 patients (4%) with a poor result. The average modified Figgie score increased from 31.2 points (range, 22-43) to 46.9 (range, 29-50) postoperatively in professional athletes; from 26.3 to 42.6 in patients who had Workers' Compensation claims but were not professional athletes; from 29.4 to 45.6 in patients with a diagnosis of loose bodies; and from 30.1 to 43.7 in patients with degenerative joint disease. There were 3 known surgical complications (1.6%) overall, 1 of which was a patient who had a transection of the ulnar nerve requiring microsurgical repair. Of the 104 patients who were contacted, 6 patients felt that their symptoms had not improved after surgery. Eight of the 55 baseball players contacted were not able to return to their same level of competition.
Conclusions:
Arthroscopy of the elbow appears to be a safe and efficacious procedure with a relatively low complication rate.