Abstract
BackgroundPosition shifting from elbow arthroscopy to open surgery could complicate the surgical procedures; patient safety and risks of contamination are of concern. The aim of this study is to retrospectively assess the safety and efficacy of elbow arthroscopy in 32 elbows of 32 patients using a modified arm holder to facilitate subsequent open surgery in supine position.MethodsWe performed a retrospective study in arthroscopy of the elbow performed with patients in the supine position under general or regional anesthesia. Arthroscopic indications were intraarticular lesions with or without second disorders. The operated arm was securely supported using an adjustable arm holder, which allowed a second surgical procedure without repositioning the patient. We recorded arthroscopic findings, clinical outcome, and complications for all patients. The average duration of follow-up was 17.1 months. Functional assessment was based on the Mayo Elbow Performance Score.ResultsAll patients had either good or excellent results with a mean Mayo Elbow Performance Score of 89.2 ± 7.2. Final motion arc averaged 113.3 ± 11.8; residual motion limitation was noted in 2 patients with preoperative ankylosis. No complications were observed immediately after surgery or during follow-up except transient paresthesia along medial cutaneous nerve in 2 patients. A total of 17 patients (53.1%) underwent other surgeries (19 procedures) after arthroscopy; 16 of these surgeries were open elbow procedures including ligament repair (7), ligament reconstruction (5), and ulnar nerve transposition (4). The average time for arthroscopy was 45.2 min; the time interval between the end of arthroscopy and the start of the second surgery procedure averaged 6.5 min.ConclusionsArthroscopy of the elbow using an adjustable arm holder with the patients in the supine position was safe and efficacious. This procedure eliminates the need for repositioning the patient and thus may facilitate subsequent concomitant surgical procedures.
Highlights
Position shifting from elbow arthroscopy to open surgery could complicate the surgical procedures; patient safety and risks of contamination are of concern
We developed a straightforward and effective method using an assembled arm holder with the patient in a supine position and examined the effectiveness and safety of the method in 32 patients
Materials and methods We conducted a retrospective study of the arthroscopic surgery in supine position, which was started since early 2007 in our hospital while an adjustable arm holder was not yet applied until 2009
Summary
Position shifting from elbow arthroscopy to open surgery could complicate the surgical procedures; patient safety and risks of contamination are of concern. The aim of this study is to retrospectively assess the safety and efficacy of elbow arthroscopy in 32 elbows of 32 patients using a modified arm holder to facilitate subsequent open surgery in supine position. The concept and technique of elbow arthroscopy was proposed by Burman in 1932 [1]. The indications for elbow arthroscopy have steadily increased over the past three decades with advancements in the equipment and techniques and the increased clinical experience [2, 3]. With diagnostic arthroscopy of the elbow being used frequently in clinical practice, surgical management of more complex. We hypothesized that elbow arthroscopy in a supine position using this adjustable arm holder was a feasible. Chen et al Journal of Orthopaedic Surgery and Research (2017) 12:20 and an efficacious option for both diagnostic purposes and for concomitant reconstruction surgery
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