The Journal of Bone and Joint Surgery 83:25 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.
Complications of Elbow Arthroscopy
Edward W. Kelly, MD,
Bernard F. Morrey, MD and
Shawn W. O'Driscoll, PhD, MD
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{at}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.
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),
débridement 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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