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A 70° Arthroscope Provides Better Visualization of the Medial Side of the Elbow Than a 30° Arthroscope
Valerio Monteleone1, Valeria Vismara2, Simone Cassin2
1Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy.
Purpose:
To assess and quantify the improvement in visualization of humeral insertion of the medial collateral ligament (MCL) using a 70° scope compared with a 30° scope during elbow arthroscopy.
Methods:
Twenty patients undergoing elbow arthroscopy for different pathologic conditions were enrolled in this single-center study. Visualization of the medial gutter of the elbow was evaluated by using both the 70° and the 30°scope. During the procedure, a needle was inserted at 45° with respect to the axis of the forearm, directed toward the intra-articular humeral emergence of the MCL. Four areas were established: the body (Z1), the lanceolate part (Z2), the tip of the needle (Z3), and the medial portion of the trochlea (Z4). The visible areas during arthroscopy using 2 different scopes were collected.
Results:
The 70° scope allowed the detection of the first 3 areas in all patients (Z1, Z2, and Z3) and the visualization of the last area (Z4) in 19 patients (95%). On the other hand, the 30° scope allowed the detection of Z1 in 85% of patients, Z2 in 60% of patients, and Z3 in only 5% of patients. The medial portion of the trochlea was never visualized with the 30° scope. These findings were statistically significant.
Conclusions:
The 70° scope improves visualization of the medial elbow compartment during elbow arthroscopy compared to the 30° scope, enhancing the extent of joint visualization and potentially permitting the detection of otherwise missed injuries in the difficult-to-reach areas of the joint.
Level Of Evidence:
Level II, diagnostic, prospective, cohort study.
