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Complications of Elbow Arthroscopy
Edward W. Kelly, MD; Bernard F. Morrey, MD; Shawn W. O'Driscoll, PhD, MD
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Investigation performed at the Mayo Clinic and Mayo Foundation, Rochester, Minnesota
Edward W. Kelly, MD
Bernard F. Morrey, MD
Shawn W. O'Driscoll, PhD, MD
Department of Orthopedics, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address for S.W. O'Driscoll: odriscoll.shawn@mayo.edu
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.
Read in part at the Annual Meeting of the American Academy of Orthopaedic Surgeons, Anaheim, California, February 6, 1999.
A complete video supplement to this article is available from the Video Journal of Orthopaedics. A video clip is available at the JBJS web site, www.jbjs.org. The Video Journal of Orthopaedics can be contacted at (805) 962-3410, web site: www.vjortho.com.

J Bone Joint Surg Am, 2001 Jan 01;83(1):25-25
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Abstract

Background: Although the potential complications of elbow arthroscopy, including nerve injuries, have been described, the prevalence of their occurrence has not been well defined. The purpose of this paper is to describe the serious and minor complications in a large series of patients treated with elbow arthroscopy.

Methods: A retrospective review of 473 consecutive elbow arthroscopies performed in 449 patients over an eighteen-year period was conducted. Of the 473 cases, 414 were followed for more than six weeks. The most common final diagnoses were osteoarthritis (150 cases), loose bodies (112), and rheumatoid or inflammatory arthritis (seventy-five). The arthroscopic procedures included synovectomy (184), d衲idement of joint surfaces or adhesions (180), excision of osteophytes (164), diagnostic arthroscopy (154), loose-body removal (144), and capsular procedures such as capsular release, capsulotomy, and capsulectomy (seventy-three).

Results: A serious complication (a joint space infection) occurred after four (0.8%) of the arthroscopic procedures. Minor complications occurred after fifty (11%) of the arthroscopic procedures. These complications included prolonged drainage from or superficial infection at a portal site after thirty-three procedures, persistent minor contracture of 20° or less after seven, and twelve transient nerve palsies (five ulnar palsies, four superficial radial palsies, one posterior interosseous palsy, one medial antebrachial cutaneous palsy, and one anterior interosseous palsy) in ten patients. The most significant risk factors for the development of a temporary nerve palsy were an underlying diagnosis of rheumatoid arthritis (p < 0.001) and a contracture (p < 0.05). There were no permanent neurovascular injuries, hematomas, or compartment syndromes in our series, and all of the minor complications, except for the minor contractures, resolved without sequelae.

Conclusions: Our results indicate that the prevalence of temporary or minor complications following elbow arthroscopy may be greater than previously reported. However, serious or permanent complications were uncommon.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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