Pediatric elbow arthroscopy: clinical outcomes and complications after long-term follow-up
Abstract Background Elbow arthroscopy is becoming increasingly important for the treatment of a wide range of acute and chronic elbow pathologies. Even if elbow arthroscopy is technically demanding, in the pediatric population this minimally invasive technique is preferred by many surgeons for the t...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-12-01
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| Series: | Journal of Orthopaedics and Traumatology |
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| Online Access: | https://doi.org/10.1186/s10195-021-00619-2 |
| _version_ | 1819106132693614592 |
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| author | Micheloni Gian Mario Tarallo Luigi Negri Alberto Giorgini Andrea Merolla Giovanni Porcellini Giuseppe |
| author_facet | Micheloni Gian Mario Tarallo Luigi Negri Alberto Giorgini Andrea Merolla Giovanni Porcellini Giuseppe |
| author_sort | Micheloni Gian Mario |
| collection | DOAJ |
| description | Abstract Background Elbow arthroscopy is becoming increasingly important for the treatment of a wide range of acute and chronic elbow pathologies. Even if elbow arthroscopy is technically demanding, in the pediatric population this minimally invasive technique is preferred by many surgeons for the treatment of pathologies such as osteochondritis dissecans (OCD), posttraumatic stiffness (PTS), or elbow posterior impingement (PI). The aim of this study is to evaluate outcomes and safety of elbow arthroscopy in the pediatric and adolescent population after long-term follow-up. Materials and methods In this retrospective study, 26 patients younger than 18 years old undergoing elbow arthroscopy were evaluated. All surgeries were performed by a single senior surgeon. Patients were divided into three subgroups based on preoperative diagnosis: OCD, PTS, and PI. After at least 60 months follow-up, several outcome measures, including range of motion (ROM), Mayo Elbow Performance Score (MEPS), and visual analog scale (VAS) were evaluated in relation to preoperative values. The level of patient satisfaction on a five-level Likert scale, any limitation or change in sport activity, and the onset of any possible complications were also evaluated. Results In the study population, we found an improvement in ROM (flexion of 14.4 ± 13.6°, extension of 19.5 ± 13.9°, pronation of 5.8 ± 5.7°, and supination of 8.5 ± 11.6°) and in validated outcome measures (MEPS of 21.0 ± 13.5 points and VAS of 3.8 ± 2.2 points). The satisfaction rate was 4.5, with no dissatisfaction. Eighty-seven percent of patients fully recovered their performance levels, 9% changed sport, and 4% were unable to return to sport. We identified one major and one minor complication, with an overall complication rate of 7.7%. No neurovascular injuries were detected. Conclusions Elbow arthroscopy in a pediatric population can be considered an effective and safe procedure for selected pathologies when performed by an experienced surgeon. At long-term follow-up, we reported excellent clinical outcomes (both objective and subjective), with a relatively low complication rate without permanent injuries. Level of evidence Level IV—case series. |
| first_indexed | 2024-12-22T02:33:17Z |
| format | Article |
| id | doaj.art-521b64f5b1c1483b828dc94475617e55 |
| institution | Directory Open Access Journal |
| issn | 1590-9921 1590-9999 |
| language | English |
| last_indexed | 2024-12-22T02:33:17Z |
| publishDate | 2021-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Orthopaedics and Traumatology |
| spelling | doaj.art-521b64f5b1c1483b828dc94475617e552022-12-21T18:41:49ZengSpringerOpenJournal of Orthopaedics and Traumatology1590-99211590-99992021-12-0122111110.1186/s10195-021-00619-2Pediatric elbow arthroscopy: clinical outcomes and complications after long-term follow-upMicheloni Gian Mario0Tarallo Luigi1Negri Alberto2Giorgini Andrea3Merolla Giovanni4Porcellini Giuseppe5Department of Orthopaedic Surgery, Azienda Ospedaliero Universitaria Di Modena, University of Modena and Reggio EmiliaDepartment of Orthopaedic Surgery, Azienda Ospedaliero Universitaria Di Modena, University of Modena and Reggio EmiliaDepartment of Orthopaedic Surgery, Azienda Ospedaliero Universitaria Di Modena, University of Modena and Reggio EmiliaDepartment of Orthopaedic Surgery, Azienda Ospedaliero Universitaria Di Modena, University of Modena and Reggio EmiliaDoctorate School in Clinical and Experimental Medicine, UNIMOREDepartment of Orthopaedic Surgery, Azienda Ospedaliero Universitaria Di Modena, University of Modena and Reggio EmiliaAbstract Background Elbow arthroscopy is becoming increasingly important for the treatment of a wide range of acute and chronic elbow pathologies. Even if elbow arthroscopy is technically demanding, in the pediatric population this minimally invasive technique is preferred by many surgeons for the treatment of pathologies such as osteochondritis dissecans (OCD), posttraumatic stiffness (PTS), or elbow posterior impingement (PI). The aim of this study is to evaluate outcomes and safety of elbow arthroscopy in the pediatric and adolescent population after long-term follow-up. Materials and methods In this retrospective study, 26 patients younger than 18 years old undergoing elbow arthroscopy were evaluated. All surgeries were performed by a single senior surgeon. Patients were divided into three subgroups based on preoperative diagnosis: OCD, PTS, and PI. After at least 60 months follow-up, several outcome measures, including range of motion (ROM), Mayo Elbow Performance Score (MEPS), and visual analog scale (VAS) were evaluated in relation to preoperative values. The level of patient satisfaction on a five-level Likert scale, any limitation or change in sport activity, and the onset of any possible complications were also evaluated. Results In the study population, we found an improvement in ROM (flexion of 14.4 ± 13.6°, extension of 19.5 ± 13.9°, pronation of 5.8 ± 5.7°, and supination of 8.5 ± 11.6°) and in validated outcome measures (MEPS of 21.0 ± 13.5 points and VAS of 3.8 ± 2.2 points). The satisfaction rate was 4.5, with no dissatisfaction. Eighty-seven percent of patients fully recovered their performance levels, 9% changed sport, and 4% were unable to return to sport. We identified one major and one minor complication, with an overall complication rate of 7.7%. No neurovascular injuries were detected. Conclusions Elbow arthroscopy in a pediatric population can be considered an effective and safe procedure for selected pathologies when performed by an experienced surgeon. At long-term follow-up, we reported excellent clinical outcomes (both objective and subjective), with a relatively low complication rate without permanent injuries. Level of evidence Level IV—case series.https://doi.org/10.1186/s10195-021-00619-2Elbow arthroscopyPediatricOsteochondritis dissecansPosttraumatic stiffnessPosterior impingement |
| spellingShingle | Micheloni Gian Mario Tarallo Luigi Negri Alberto Giorgini Andrea Merolla Giovanni Porcellini Giuseppe Pediatric elbow arthroscopy: clinical outcomes and complications after long-term follow-up Journal of Orthopaedics and Traumatology Elbow arthroscopy Pediatric Osteochondritis dissecans Posttraumatic stiffness Posterior impingement |
| title | Pediatric elbow arthroscopy: clinical outcomes and complications after long-term follow-up |
| title_full | Pediatric elbow arthroscopy: clinical outcomes and complications after long-term follow-up |
| title_fullStr | Pediatric elbow arthroscopy: clinical outcomes and complications after long-term follow-up |
| title_full_unstemmed | Pediatric elbow arthroscopy: clinical outcomes and complications after long-term follow-up |
| title_short | Pediatric elbow arthroscopy: clinical outcomes and complications after long-term follow-up |
| title_sort | pediatric elbow arthroscopy clinical outcomes and complications after long term follow up |
| topic | Elbow arthroscopy Pediatric Osteochondritis dissecans Posttraumatic stiffness Posterior impingement |
| url | https://doi.org/10.1186/s10195-021-00619-2 |
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