Preventing Complications in Arthroscopic Surgery
The risk of complications of elbow arthroscopy remains a concern. Regardless the type of positioning, it is important that the surgeon be the one to do it. Proper fluid inflow and outflow is mandatory to prevent the elbow from getting swollen, as swelling can reduce joint visualization and increase the risk of severe complications. Suction has to be avoided while working close to neurological structures. A stepwise technique is the best way to reduce the risk of complications. An accurate knowledge of the anatomy (particularly of the nerves around the elbow) is the basis of proper and safe portal placement. Ulnar nerve decompression helps the surgeon to safely place the anteromedial portals. The use of retractors improves the joint visualization, reduces the length of the procedure, and helps the surgeon to protect neurovascular structures. To reduce extensive hematoma, the use of tranexamic acid at the end of the procedure can be helpful, and post-op drains are usually indicated for 24 h after surgery.
KeywordsElbow arthroscopy Safety Fluid management Retractors Portals Neurologic complications
To Dr Shawn W. O’Driscoll, who has been a patient teacher, who provided time and detailed attention to teaching the authors, and so many more.
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