Summary
The first comprehensive presentation of available data evaluating complications associated with elbow arthroscopy in adults and children
Abstract
Purpose
An overview of complications in elbow arthroscopy is scarce but essential to optimize informed consent for operative treatment and further improve training programs for orthopedic surgeons. This study aims to assess the incidence and type of complications associated with elbow arthroscopy in adults and children.
Methods
A literature search was performed in the PubMed, EMBASE, and Cochrane databases. Studies with at least five patients reporting complications or reoperations after elbow arthroscopy were included. The primary outcome measures were the complication and reoperation rate following elbow arthroscopy in the overall population, and in the adult and pediatric population separately. Based on the Nelson- and Dindo-Clavien classification, complications were categorized as minor or major and Grade 1 to 5, respectively.
Results
In 114 articles, a total of 18892 arthroscopies were performed in 16815 patients. The complication rate ranged from 0% to 71% and reoperation rate from 0% to 59%. Most frequently observed complications were transient nerve palsies (1.5%), superficial infections (0.9%), and contractures (0.7%). Of these complications, 735 (81%) were rated as minor and 171 (19%) as major complications. Forty-nine studies show a complication rate from 0% to 28% in an adult population, with transient nerve palsies as the most common complication. Ten studies show a complication rate from 0% to 57% in a pediatric population, with residual or recurrent loose bodies following surgery as the most common complication.
Conclusion
Elbow arthroscopy demonstrates a complication rate from 0% to 71%. Nineteen percent of the complications were major complications.
Clinical Relevance: This review shows that elbow arthroscopy has a similar complication rate to arthroscopy of other joints. The risk of major complications, particularly nerve injury, should be discussed with patients.