Arthroscopy. 2023 Nov;39(11):2388-2391. doi: 10.1016/j.arthro.2023.06.011.
Elbow arthroscopy enables surgeons to treat a vast range of elbow injuries and pathologies in a minimally invasive manner. It has a lower morbidity rate and is often followed by a faster recovery than traditional open surgery unless it is followed by a serious complication. Although most complications are minor and transient, the incidence of both minor and major complications is considerably higher than that after arthroscopy of other joints, specifically the risk of neurovascular injury including permanent nerve injury because of the proximity of neurovascular structures. A recent review of 114 studies reported a median 3% incidence of complications and 2% incidence of reoperation, with transient nerve palsies accounting for about one third. Surgeon experience may influence complication rates; a survey suggested that surgeons need to experience more than 200 cases to be considered expert. In addition, patient-related factors such as obesity, female gender, age over 65 years, elevated blood sugar levels, hypercoagulable disorder, tobacco or alcohol use or both, as well as history of previous surgery and perioperative corticosteroid injections are identified as risk factors for complications after elbow arthroscopy. Keys to avoiding complications include precise surgical indications and understanding the 3-dimensional anatomy-especially the relationship of the various nerves to the portals and joint capsule.
肘关节镜使外科医生能够以微创的方式治疗广泛的肘部损伤和病变。与传统的开放性手术相比，它的发病率较低，恢复速度通常更快，但除非出现严重并发症。虽然大多数并发症是轻微和短暂的，但无论是轻微还是严重并发症的发生率都明显高于其他关节的关节镜检查，特别是神经血管损伤的风险，包括由于神经血管结构的接近而导致的永久性神经损伤。最近对 114 项研究的综述报告并发症的中位数发生率为 3%，再次手术的发生率为 2%，短暂性神经麻痹约占三分之一。外科医生的经验可能会影响并发症的发生率；一项调查表明，外科医生需要进行超过 200 例手术才能被认为是专家。此外，患者相关因素，如肥胖、女性、年龄超过 65 岁、血糖水平升高、高凝状态、吸烟或饮酒或两者兼有，以及既往手术史和围手术期皮质类固醇注射，被确定为肘关节镜检查后并发症的危险因素。避免并发症的关键包括准确的手术适应证和了解三维解剖结构——特别是各种神经与入路和关节囊的关系。
