Arthroscopy of the elbow: A long-term clinical review

Purpose: The purpose of this study was to review a large group of patients who had arthroscopy of the elbow to determine the efficacy and relative ris ks of this procedure. Type of Study: We retrospectively reviewed a convenie nt sample of 172 patients who underwent 187 arthroscopies of the elbow over a 7-year period. Materials and Methods: All patients had their charts and radiographs reviewed, and 104 of these patients were also contacted for a t elephone interview at an average follow-up of 42.3 months (range, 7 to 115 months). Results: The procedures were performed primarily by 7 different su rgeons, using all 3 standard operating positions and a variety of arthrosco pic portals. The most common diagnosis was posterior impingement in 96 pati ents (51%), followed by loose bodies in 72 patients (31%), and degenerative joint disease in 32 patients (22%). The average preoperative modified Figg ie score was 27.7 points (range, 17-43) for all patients. The average posto perative score was 45.4 points (range, 29-50), with the largest increase oc curring in the pain score. There were 51 patients (56%) with an excellent s urgical result, 37 patients (36%) with a good result, 12 patients (11%) wit h a fair result, and 4 patients (4%) with a poor result. The average modifi ed Figgie score increased from 31.2 points (range, 22-43) to 46.9 (range, 2 9-50) postoperatively in professional athletes; from 26.3 to 42.6 in patien ts who had Workers' Compensation claims but were not professional athletes; from 29.4 to 45.6 in patients with a diagnosis of loose bodies; and from 3 0.1 to 43.7 in patients with degenerative joint disease. There were 3 known surgical complications (1.6%) overall, 1 of which was a patient who had a transection of the ulnar nerve requiring microsurgical repair. Of the 104 p atients who were contacted, 6 patients felt that their symptoms had not imp roved after surgery. Eight of the 55 baseball players contacted were not ab le to return to their same level of competition. Conclusions: Arthroscopy o f the elbow appears to be a safe and efficacious procedure with a relativel y low complication rate.