Complications of Elbow Arthroscopic Surgery: A Systematic Review and Meta-analysis

Abstract

Background: Elbow arthroscopic surgery has been popularized and has made significant progress during the past 3 decades. The elbow joint is relatively small and is in close proximity to many neurovascular structures. These factors make elbow arthroscopic surgery technically demanding and liable to complications. Purpose: To evaluate the rate of complications after elbow arthroscopic surgery. Study Design: Systematic review; Level of evidence, 4. Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to perform this systematic review and meta-analysis. PubMed, Web of Science, and Embase were searched up to July 2021. All clinical studies that reported complications after elbow arthroscopic surgery were included; a total of 1208 articles were initially found. Case reports, reviews, abstracts, imaging studies, technique studies, nonclinical studies, and those not reporting postoperative complications were excluded. Complication rates were pooled across studies and reported as percentages. Complications were expressed as weighted proportions with 95% CIs. Results: A total of 95 studies (14,289 elbows) were included in the meta-analysis. The overall weighted complication rate was 11.0% (95% CI, 8.8%-13.5%), with postoperative stiffness being the most commonly encountered complication (4.5% [95% CI, 2.1%-7.6%]; 158/8818 procedures). The second most encountered complication was the need for subsequent surgery with a weighted proportion of 4.1% (95% CI, 2.9%-5.6%; 177/8853 procedures) followed by nerve injury with a weighted proportion of 3.4% (95% CI, 2.6%-4.3%; 267/13,725 procedures). The ulnar nerve was the most commonly injured nerve (2.6% [95% CI, 1.9%-3.4%]; 123/6290 procedures). Conclusion: The results of this study showed that elbow arthroscopic surgery is a relatively safe procedure with low complication rates.

Have Elbow Arthroscopy Hospitalizations Decreased over the Years? An Epidemiological Italian Study from 2001 to 2016

“…These two new tests can provide a reasonable tool to assess lateral elbow pain to help in diagnosis before arthroscopic surgery [ 22 ]. Nowadays, the range of indications has increased to include treatment for more difficult pathologies including radial head resection, the management of intraarticular fractures, total synovectomy, and ligament repair [ 23 ]. The use of arthroscopy procedures will increase as they become more standardized and common, lowering the risk of stiffness and speeding up recovery [ 19 ].…”

Outcomes of arthroscopic elbow synovectomy and neurolysis of the ulnar nerve for tenosynovial giant cell tumor in a young athlete: a case report and literature review

“…Elbow arthroscopic surgery is a minimally invasive surgical procedure with relatively low complication rates. 2 Common indications may include loose body extraction, contracture release, synovectomy, and lateral epicondylitis release. In addition, the indications have been extended to include more complex conditions such as radial head resection, arthroscopically assisted fixation of intra-articular fractures, total synovectomy, and ligament reconstruction.…”

“…In addition, the indications have been extended to include more complex conditions such as radial head resection, arthroscopically assisted fixation of intra-articular fractures, total synovectomy, and ligament reconstruction. 2 , 3 , 10 …”

“… 5 Open synovectomy has been associated with complications such as infection risk, suture dehiscence, joint stiffness, and postoperative pain 6 An arthroscopic synovectomy is minimally invasive and has been found to have fewer complications and a faster postoperative recovery time. 2 , 6 …”

Management of the stiff elbow: a literature review

“…Perioperative IA corticosteroid injections remain a topic of debate, with significant effects in the prevention of HO ( 20 ). However, multiple studies have shown that IA corticosteroid injections are significantly associated with the development of postoperative infection ( 20 , 21 , 22 ).…”