Clinical Review

Quality and Quantity of the Elbow Arthroscopy Literature: A Systematic Review and Meta-Analysis

Am J Orthop. 2016 July;45(5):E290-E298

References

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The most common surgical indications were OCD (Figure 4), lateral epicondylitis (Figure 5), and release and débridement (Figure 6, Table 3; all studies listed indications). The number of reported cases for these 3 indications significantly increased over time (OCD P = .005, lateral epicondylitis P = .044, release and débridement P = .042) but did not significantly differ between regions (P > .05 in all cases).

Thirty-two (28.6%) studies reported the use of outcome measures (16 different outcome scores were used by the included studies). Asia reported outcome measures in 9 of 23 studies (39%), Europe in 12 of 35 studies (34%) and North America in 11 of 54 (20%) of studies. The MEPS was the most frequently used outcome score in 9.8% of studies, followed by VAS for pain in 5.3% of cases. North American studies reported a significantly higher increase in extension after elbow arthroscopy than Asia (P = .0432) (Figure 7), with no differences in flexion (P = .699), pronation (P = .376), or supination (P = .408). No significant differences were observed between continents in the type of anesthesia chosen (general anesthesia [P = .94] or regional anesthesia [P = .85]). Asia and Europe performed elbow arthroscopy most frequently in the lateral decubitus position, while North American studies most often used the supine position (Table 4).

Twenty (17.9%) studies reported the use of a postoperative splint, 12 (10.7%) studies reported use of a drain, 2 (1.79%) studies reported use of a hinged elbow brace, 9 (8.03%) studies reported use of a continuous passive motion machine postoperatively, and 3 (2.68%) studies reported use of an indwelling axillary catheter for postoperative pain management. Of 130 reported surgical complications (4.1%), the most frequent complication was transient sensory ulnar nerve palsy (1.5%), followed by persistent wound drainage (.76%), and transient sensory radial nerve palsy (.38%). Other reported complications included infection (.22%), transient sensory palsy of the median nerve (.19%), heterotopic ossification (.13%), complete transection of the ulnar nerve (.10%), loose body formation (.06%), hematoma formation (.06%), transient sensory palsy of the posterior interosseous (.06%), or anterior interosseous nerve (.03%), and complete transection of the radial (.03%), or median nerve (.03%).