Arthroscopic elbow surgery, is it safe?

BackgroundDuring the past 10 years, the use of arthroscopic elbow surgery has increased tremendously. The proximity of neurovascular structures and narrow joint spaces make it a technically demanding procedure with many potential complications. The purpose of this study was to report the complications in a large series of patients and identify factors that might have contributed to their occurrence.Materials and methodsDuring an 8-year period, 200 elbow arthroscopies were performed by a single surgeon. All procedures were performed in a standardized fashion. Patient records were reviewed by independent observers. The minimum follow-up for all patients was 8 weeks.ResultsThe only major permanent complication (0.5%) identified was an ulnar nerve injury. Minor complications were identified in 14 patients (7%): 3 transient nerve palsies, 4 prolonged serous drainages or superficial wound infections, 6 persistent elbow contractures, and 1 mild increase in contracture. Of reported patients with complications, 9 (60%) had a history of trauma, fracture, or previous surgery. In 11 patients with direct surgery-related complications, 8 (73%) had a similar history.ConclusionThe complications encountered in our series are well within the limits of earlier reports and show that with only a 0.5% rate of major complications, elbow arthroscopy is a relatively safe procedure for a wide variety of indications when performed in a standardized fashion. In patients with a history of trauma or previous surgery, the procedure is more challenging and, in less experienced hands, might lead to higher complication rates.