TY - JOUR
T1 - Wide Range in Complication Rates Following Elbow Arthroscopy in Adult and Pediatric Patients
T2 - A Systematic Review
AU - de Klerk, Huub H.
AU - Verweij, Lukas P.E.
AU - Sierevelt, Inger N.
AU - Priester-Vink, Simone
AU - Hilgersom, Nick F.J.
AU - Eygendaal, Denise
AU - van den Bekerom, Michel P.J.
N1 - Funding Information: One or more of the authors (H.K.) has received funding from De Stichting Prof. Michaël-van Vloten Fonds (the Hague, the Netherlands), the Fundatie van Renswoude (‘s-Gravenhage, the Netherlands), the Stichting Anna Fonds | NOREF (Mijdrecht, the Netherlands), the Stichting het Scholten-Cordes Fonds (the Hague, the Netherlands), and the USC Scholarship Foundation (Utrecht, the Netherlands), but this has no relation to this article. Publisher Copyright: © 2023 Arthroscopy Association of North America
PY - 2023/11
Y1 - 2023/11
N2 - Purpose: To perform a systematic review of complications associated with elbow arthroscopy in adults and children. Methods: A literature search was performed in the PubMed, EMBASE, and Cochrane databases. Studies reporting complications or reoperations after elbow arthroscopy with at least 5 patients were included. Based on the Nelson classification, the severity of complications was categorized as minor or major. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized clinical trials, and nonrandomized trials were assessed using the Methodological Items for Non-randomized Studies (MINORS) tool. Result: A total of 114 articles were included with 18,892 arthroscopies (16,815 patients). A low risk of bias was seen for the randomized studies and a fair quality for the nonrandomized studies. Complication rates ranged from 0% to 71% (median 3%; 95% confidence interval [CI], 2.8%-3.3%), and reoperation rates from 0% to 59% (median 2%; 95% CI, 1.8%-2.2%). A total of 906 complications were observed, with transient nerve palsies (31%) as the most frequent complication. According to Nelson classification, 735 (81%) complications were minor and 171 (19%) major. Forty-nine studies reported complications in adults and 10 studies in children, showing a complication rate ranging from 0% to 27% (median 0%; 95% CI, 0%-0.4%) and 0% to 57% (median 1%; 95% CI, 0.4%-3.5%), respectively. A total of 125 complications were observed in adults, with transient nerve palsies (23%) as the most frequent complication, and 33 in children, with loose bodies after surgery (45%) as the most frequent complication. Conclusions: Predominantly low-level evidence studies demonstrate varying complication rates (median 3%, range 0%-71%) and reoperation rates (median 2%, range 0%-59%) after elbow arthroscopy. Higher complication rates are observed after more complex surgery. The incidence and type of complications can aid surgeons in patient counseling and refining surgical techniques to further reduce the complication rates. Level of Evidence: Level IV; systematic review of Level I-IV studies.
AB - Purpose: To perform a systematic review of complications associated with elbow arthroscopy in adults and children. Methods: A literature search was performed in the PubMed, EMBASE, and Cochrane databases. Studies reporting complications or reoperations after elbow arthroscopy with at least 5 patients were included. Based on the Nelson classification, the severity of complications was categorized as minor or major. Risk of bias was assessed using the Cochrane risk-of-bias tool for randomized clinical trials, and nonrandomized trials were assessed using the Methodological Items for Non-randomized Studies (MINORS) tool. Result: A total of 114 articles were included with 18,892 arthroscopies (16,815 patients). A low risk of bias was seen for the randomized studies and a fair quality for the nonrandomized studies. Complication rates ranged from 0% to 71% (median 3%; 95% confidence interval [CI], 2.8%-3.3%), and reoperation rates from 0% to 59% (median 2%; 95% CI, 1.8%-2.2%). A total of 906 complications were observed, with transient nerve palsies (31%) as the most frequent complication. According to Nelson classification, 735 (81%) complications were minor and 171 (19%) major. Forty-nine studies reported complications in adults and 10 studies in children, showing a complication rate ranging from 0% to 27% (median 0%; 95% CI, 0%-0.4%) and 0% to 57% (median 1%; 95% CI, 0.4%-3.5%), respectively. A total of 125 complications were observed in adults, with transient nerve palsies (23%) as the most frequent complication, and 33 in children, with loose bodies after surgery (45%) as the most frequent complication. Conclusions: Predominantly low-level evidence studies demonstrate varying complication rates (median 3%, range 0%-71%) and reoperation rates (median 2%, range 0%-59%) after elbow arthroscopy. Higher complication rates are observed after more complex surgery. The incidence and type of complications can aid surgeons in patient counseling and refining surgical techniques to further reduce the complication rates. Level of Evidence: Level IV; systematic review of Level I-IV studies.
UR - http://www.scopus.com/inward/record.url?scp=85164159164&partnerID=8YFLogxK
U2 - 10.1016/j.arthro.2023.04.015
DO - 10.1016/j.arthro.2023.04.015
M3 - Review article
C2 - 37146664
SN - 0749-8063
VL - 39
SP - 2363
EP - 2387
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 11
ER -