Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Search research articles

Related Experiment Videos

Medial approach in elbow arthroscopy.

T N Lindenfeld¹

¹Cincinnati Sportsmedicine Orthopaedic Center, Deaconess Hospital, OH 45219.

The American Journal of Sports Medicine

|July 1, 1990

Summary

Starting elbow arthroscopy with the anterior medial portal offers greater safety compared to the anterior radial portal. This cadaveric study found the medial approach provides significantly more space between instruments and vital nerves and arteries.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies.

The Journal of the American Academy of Orthopaedic Surgeons·2000

Same author

Surgical treatment of arthrofibrosis of the knee.

Instructional course lectures·2000

Same author

Spinal process apophysitis mimics spondylolysis. Case reports.

The American journal of sports medicine·2000

Same author

The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study.

The American journal of sports medicine·1999

Same author

Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes.

The American journal of sports medicine·1998

Same author

Early rehabilitation after a modified inferior capsular shift procedure for multidirectional instability of the shoulder.

Orthopedics·1998

Area of Science:

Orthopedic Surgery
Anatomy
Surgical Techniques

Background:

Elbow arthroscopy is a common procedure for diagnosing and treating various joint conditions.
The choice of initial portal placement in elbow arthroscopy can impact safety and efficacy.
Current standard techniques often begin with the anterior radial portal.

Purpose of the Study:

To compare the safety of initiating elbow arthroscopy via an anterior medial portal versus an anterior radial portal.
To determine the proximity of neurovascular structures to the arthroscopic sheath in both approaches.

Main Methods:

A cadaveric dissection study was performed on six elbows.
Capsular distension was achieved using saline followed by expanding polyurethane foam.
Both anterior medial and anterior radial portals were created with the elbow at 90 degrees flexion.
Minimum distances from the arthroscopic sheath path to the radial nerve, median nerve, and brachial artery were measured after foam hardening.

Main Results:

The anterior medial portal demonstrated a significantly greater average minimum distance (23 mm) to the nearest neurovascular structures (median nerve, brachial artery) compared to the anterior radial portal (3 mm to the radial nerve).
The ulnar nerve had an average clearance of 25 mm from the medial portal.
Even with an incorrectly placed medial portal, the minimum clearance to the median nerve averaged 11 mm.

Conclusions:

The anterior medial portal is a safer starting point for elbow arthroscopy than the anterior radial portal.
This approach offers superior protection against iatrogenic injury to critical neurovascular structures.
Findings suggest a potential modification to the standard technique for improved patient safety.

Related Experiment Videos