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The first 100 elbow arthroscopies of one surgeon: analysis of complications

Darius Marti, Christian Spross & Bernhard Jost

abstract

BACKGROUND
Elbow arthroscopy is technically challenging and prone to complications especially due to the close relation of nerves and vessels. Complication rates up to 20% are reported, depending on indication and how complications are defined. This study analyzes the complications of the first 100 elbow arthroscopies done by 1 fellowship- and cadaver-trained surgeon.

MATERIALS AND METHODS
From September 2004 to April 2009, 100 consecutive elbow arthroscopies were performed, and thus consequently standardized, by 1 surgeon in 1 institution. The clinical data of all patients were retrospectively analyzed for indication-specific complications. Complications were divided into minor (transient) and major (persistent or infection).

RESULTS
Included were 65 male and 35 female patients (mean age, 41 years; range, 12-70 years) with a minimum follow-up of 12 months (clinical or telephone). The following indications were documented (several per patient were possible): osteoarthritis in 29, stiffness in 27, loose bodies in 27, tennis elbow in 24, traumatic sequelae in 19, and others in 24. No major complications occurred, but 6 minor complications occurred in 5 patients (5%), comprising 2 hematoma, 2 transient nerve lesions, 1 wound-healing problem, and 1 complex regional pain syndrome. No revision surgery was necessary. Complications were not significantly associated with the indication for operation or the surgeon's learning curve.

CONCLUSION
This study shows an acceptable complication rate of the first 100 elbow arthroscopies from a single surgeon. A profound clinical education, including cadaver training as well as standardization of patient position, portals, and surgery, help to achieve this.
   
citation Marti D, Spross C, Jost B. The first 100 elbow arthroscopies of one surgeon: analysis of complications. J Shoulder Elbow Surg 2013; 22:567-73.
   
type journal paper/review (English)
date of publishing 15-02-2013
journal title J Shoulder Elbow Surg (22/4)
ISSN electronic 1532-6500
pages 567-73
PubMed 23419603
DOI 10.1016/j.jse.2012.12.001