Abstract
Elbow arthroscopy has not become a commonly performed procedure for a multitude of reasons, not the least of which is the steep learning curve of the technique. Outside of a few individuals in very specialized practices, very few surgeons who concentrate on the upper limb have a steady flow of pediatric patients that would benefit from elbow arthroscopy. The surgery is technically challenging, is not performed at a high volume in most training centers, and carries with it substantial risks. Even a basic diagnostic arthroscopy is challenging for the novice. Additionally, there is nothing in the elbow that can be done arthroscopically that can’t be done open.
However, the elbow is an unforgiving joint, and the promise of decreasing the surgical insult to the elbow from the use of arthroscopic techniques is appealing. For those surgeons wishing to provide elbow arthroscopy to their patients, some form of hands-on instruction is highly recommended. Begin by incorporating the arthroscope as an adjunct to open procedures where visualization inside the joint would be of benefit. Progress to simple arthroscopic techniques where conversion to the open technique is easily accomplished. Arthroscopy is ideal for the treatment of osteochondritis dissecans, posterolateral plicas, and intra-articular loose bodies. Do not attempt an arthroscopy in a patient with altered anatomy, either because of trauma or disease, without having some experience with this technique.
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References
Ansah P, Vogt S, Ueblacker P, Martinek V, Woertler K, Imhoff AB. Osteochondral transplantation to treat osteochondral lesions in the elbow. J Bone Joint Surg Am. 2007;89:2188–94.
Bilsel K, Demirhan M, Atalar AC, Akkaya S. A new surgical technique to facilitate osteochondral autograft transfer in osteochondral defects of the capitellum: a case report. Acta Orthop Traumatol Turc. 2010;44:82–7.
Blonna D, Wolf JM, Fitzsimmons JS, O'Driscoll SW. Prevention of nerve injury during arthroscopic capsulectomy of the elbow utilizing a safety-driven strategy. J Bone Joint Surg Am. 2013;95(15):1373–81.
Gudas R, Gudaite A, Pocius A, Gudiene A, Cekanauskas E, Monastyreckiene E, Basevicius A. Ten-year follow-up of a prospective, randomized clinical study of mosaic osteochondral autologous transplantation versus microfracture for the treatment of osteochondral defects in the knee joint of athletes. Am J Sports Med. 2012;40:2499–508.
Iwasaki N, Kato H, Ishikawa J, Saitoh S, Minami A. Autologous osteochondral mosaicplasty for capitellar osteochondritis dissecans in teenaged patients. Am J Sports Med. 2006;34:1233–9.
Iwasaki N, Kato H, Ishikawa J, Masuko T, Funakoshi T, Minami A. Autologous osteochondral mosaicplasty for osteochondritis dissecans of the elbow in teenage athletes. J Bone Joint Surg Am. 2009;91:2359–66.
Kelly EW, Morrey BF, O’Driscoll SW. Complications of elbow arthroscopy. J Bone Joint Surg Am. 2001;83(1):25–34.
Kim DH, Gambardella RA, Elattrache NS, Yocum LA, Jobe FW. Arthroscopic treatment of posterolateral elbow impingement from lateral synovial plicae in throwing athletes and golfers. Am J Sports Med. 2006;34(3):438–44.
Kosaka M, Nakase J, Takahashi R, Toratani T, Ohashi Y, Kitaoka K, Tsuchiya H. Outcomes and failure factors in surgical treatment for osteochondritis dissecans of the capitellum. J Pediatr Orthop. 2013;33(7):719–24.
Ovesen J, Olsen BS, Johannsen HV. The clinical outcomes of mosaicplasty in the treatment of osteochondritis dissecans of the distal humeral capitellum of young athletes. J Shoulder Elbow Surg. 2011;20:813–8.
Ruch DS, Papadonikolakis A, Campolattaro RM. The posterolateral plica: a cause of refractory lateral elbow pain. J Shoulder Elbow Surg. 2006;15(3):367–70.
Savoie FH. Guidelines to becoming an expert elbow arthroscopist. Arthroscopy. 2007;23(11):1237–40.
Shi LL, Bae DS, Kocher MS, Micheli LJ, Waters PM. Contained versus uncontained lesions in juvenile elbow osteochondritis dissecans. J Pediatr Orthop. 2012;32(3):221–5.
Shimada K, Yoshida T, Nakata K, Hamada M, Akita S. Reconstruction with an osteochondral autograft for advanced osteochondritis dissecans of the elbow. Clin Orthop Relat Res. 2005;435:140–7.
Shimada K, Tanaka H, Matsumoto T, Miyake J, Higuchi H, Gamo K, Fuji T. Cylindrical costal osteochondral autograft for reconstruction of large defects of the capitellum due to osteochondritis dissecans. J Bone Joint Surg Am. 2012;94:992–1002.
Steinert AF, Goebel S, Rucker A, Barthel T. Snapping elbow caused by hypertrophic synovial plica in the radiohumeral joint: a report of three cases and review of literature. Arch Orthop Trauma Surg. 2010;130(3):347–51.
Tsuda E, Ishibashi Y, Sato H, Yamamoto Y, Toh S. Osteochondral autograft transplantation for osteochondritis dissecans of the capitellum in nonthrowing athletes. Arthroscopy. 2005;21:1270e1–4.
Vogt S, Siebenlist S, Hensler D, Weigelt L, Ansah P, Woertler K, Imhoff AB. Osteochondral transplantation in the elbow leads to good clinical and radiologic long-term results: an 8- to 14-year follow-up examination. Am J Sports Med. 2011;39:2619–25.
Yamamoto Y, Ishibashi Y, Tsuda E, Sato H, Toh S. Osteochondral autograft transplantation for osteochondritis dissecans of the elbow in juvenile baseball players: minimum 2-year follow-up. Am J Sports Med. 2006;34:714–20.
Yonetani Y, Matsuo T, Nakamura N, Natsuume T, Tanaka Y, Shiozaki Y, Wakitani S, Horibe S. Fixation of detached osteochondritis dissecans lesions with bioabsorbable pins: clinical and histologic evaluation. Arthroscopy. 2010;26(6):782–9.
Further Reading
Bradley JP, Petrie RS. Osteochondritis dissecans of the humeral capitellum: diagnosis and treatment. Clin Sports Med. 2001;20:565–90.
Gudas R, Gudaitė A, Mickevičius T, Masiulis N, Simonaitytė R, Cekanauskas E, Skurvydas A. Comparison of osteochondral autologous transplantation, microfracture, or debridement techniques in articular cartilage lesions associated with anterior cruciate ligament injury: a prospective study with a 3-year follow-up. Arthroscopy. 2013;29:89–97.
Kobayashi K, Burton KJ, Rodner C, Smith B, Caputo AE. Lateral compression injuries in the pediatric elbow: Panner’s disease and osteochondritis dissecans of the capitellum. J Am Acad Orthop Surg. 2004;12:246–54.
Mihara K, Tsutsui H, Nishinaka N, Yamaguchi K. Oblique osteochondral plugs transplantation technique for osteochondritis dissecans of the elbow joint. Knee Surg Sports Traumatol Arthrosc. 2009;17:204–8.
Schenck Jr RC, Goodnight JM. Osteochondritis dissecans. J Bone Joint Surg Am. 1996;78:439–56.
Schub DL, Frisch NC, Bachmann KR, Winalski C, Saluan PM. Mapping of cartilage depth in the knee and elbow for use in osteochondral autograft procedures. Am J Sports Med. 2013;41(4):903–7.
Yadao MA, Field LD, Savoie III FH. Osteochondritis dissecans of the elbow. Instr Course Lect. 2004;53:599–606.
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Zlotolow, D.A. (2015). Elbow Arthroscopy. In: Abzug, J., Kozin, S., Zlotolow, D. (eds) The Pediatric Upper Extremity. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8515-5_77
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DOI: https://doi.org/10.1007/978-1-4614-8515-5_77
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