Pediatric Patients who Underwent Elbow Arthroscopy had an 86% Return to Sport Rate, a 12% Reoperation Rate, and a 3.7% Complication Rate

Abstract

PurposeThe purpose of this study was to assess the applicability and safety of elbow arthroscopy in the pediatric population at our institution by analyzing the indications and complications in a large pediatric patient series. MethodsAll patients who underwent elbow arthroscopy at 18 years of age or younger from 2006 to 2017 by a single fellowship-trained surgeon were retrospectively identified. Exclusion criteria were a follow-up shorter than eight weeks and open surgeries (not fully arthroscopic). Medical records were reviewed for baseline characteristics, indications for elbow arthroscopy, range of motion, complications, and reoperations. Results191 patients (64 boys and 127 girls) were included with a median age of 15.5 years (IQR 14.0-16.7). Indications for arthroscopic surgery were grouped into treatment of osteochondritis dissecans (60%), debridement for bony or soft tissue pathology (35%), contracture release (3%), and diagnostic arthroscopy (3%). The complication rate was 3.7%, including 4 minor complications (3 superficial wound problems, 1 transient ulnar neuropathy) and 3 major complications (1 manipulation under anesthesia for stiffness, 1deep infection, 1 (unplanned) reoperation for persistent locking within 1 year of the index procedure). 23 patients (12%) needed subsequent surgery because of newly developed, persisting or recurring elbow problems. 86% were able to return to sports. ConclusionsPediatric elbow arthroscopy performed by an experienced surgeon using a standardized technique for a wide variety of elbow conditions has an acceptable complication rate that is similar to previously published literature on elbow arthroscopy in the pediatric and adult populations; however, a significant proportion of patients needed subsequent surgery in the following years.