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Basics of Elbow Arthroscopy

February 10, 2018

Contributors: David W Altchek, MD; Christopher L. Camp, MD; Ryan Degen, FRCSC, MD, MSc; Joshua Dines, MD; Joaquin Sanchez-Sotelo, MD; Venkat Boddapati, BA; Venkat Boddapati, BA

As our knowledge and technology advance, the indications for elbow arthroscopy rapidly continue to grow. A number of new portals have been described and reported using variable nomenclature and location descriptions. Therefore, a comprehensive review of these portals is warranted. Given the concern for iatrogenic injury to surrounding neurovascular structures, a discussion of these critical nerves and vessels also is warranted. The first part of this video reviews pertinent surface anatomy; portal nomenclature, locations, and utility; and distances to the nearest structures at risk. The second part of this video discusses the change from the supine hanging position to the supine suspended position with the use of a mechanical arm holder. Currently, the supine suspended and lateral decubitus positions are the two techniques most commonly used for elbow arthroscopy. This video also describes the history of the supine position, key points for proper patient positioning, and the steps for diagnostic elbow arthroscopy. We hope this video will serve as a current review and summary of the most critical components of elbow arthroscopy. The third part of this video discusses the history, patient positioning, and key steps for performing elbow arthroscopy in the lateral decubitus position. In addition to key steps, a number of advantages and disadvantages of the lateral decubitus position are discussed in detail. If properly executed, elbow arthroscopy can be performed in a safe and efficient manner with minimal risk to patients.

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