1
|
Teule EHS, Hummelink S, Kumaş A, Buckens CFM, Sechopoulos I, van der Heijden EPA. Automatic analysis of the scapholunate distance using 4DCT imaging: normal values in the healthy wrist. Clin Radiol 2024; 79:e1040-e1048. [PMID: 38797610 DOI: 10.1016/j.crad.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024]
Abstract
AIM Early diagnosis of scapholunate ligament (SLL) injuries is crucial to prevent progression to debilitating osteoarthritis. Four-Dimensional Computed Tomography (4DCT) is a promising dynamic imaging modality for assessing such injuries. Capitalizing on the known correlation between SLL injuries and an increased scapholunate distance (SLD), this study aims to develop a fully automatic approach to evaluate the SLD continuously during wrist motion and to apply it to a dataset of healthy wrists to establish reference values. MATERIALS AND METHODS 50 healthy wrists were analysed in this study. All subjects performed radioulnar deviation (RUD), flexion-extension (FE), and clenching fist (CF) movements during 4DCT acquisition. A novel, automatic method was developed to continuously compute the SLD at five distinct locations within the scapholunate joint, encompassing a centre, volar, dorsal, proximal, and distal measurement. RESULTS The developed algorithm successfully processed datasets from all subjects. Our results showed that the SLD remained below 2 mm and exhibited minimal changes (median ranges between 0.3 mm and 0.65 mm) during RUD and CF at all measured locations. During FE, the volar and dorsal SLD changed significantly, with median ranges of 0.90 and 1.27 mm, respectively. CONCLUSION This study establishes a unique database of normal SLD values in healthy wrists during wrist motion. Our results indicate that, aside from RUD and CF, FE may also be important in assessing wrist kinematics. Given the labour-intensive and time-consuming nature of manual analysis of 4DCT images, the introduction of this automated algorithm enhances the clinical utility of 4DCT in diagnosing dynamic wrist injuries.
Collapse
Affiliation(s)
- E H S Teule
- Radboud University Medical Centre, Department of Plastic, Reconstructive, and Hand Surgery, Nijmegen, the Netherlands; Radboud University Medical Centre, Orthopaedic Research Lab, Nijmegen, the Netherlands.
| | - S Hummelink
- Radboud University Medical Centre, Department of Plastic, Reconstructive, and Hand Surgery, Nijmegen, the Netherlands.
| | - A Kumaş
- Radboud University Medical Centre, Department of Plastic, Reconstructive, and Hand Surgery, Nijmegen, the Netherlands.
| | - C F M Buckens
- Radboud University Medical Centre, Department of Medical Imaging, Nijmegen, the Netherlands.
| | - I Sechopoulos
- Radboud University Medical Centre, Department of Medical Imaging, Nijmegen, the Netherlands; University of Twente, Technical Medical Centre, Enschede, the Netherlands.
| | - E P A van der Heijden
- Radboud University Medical Centre, Department of Plastic, Reconstructive, and Hand Surgery, Nijmegen, the Netherlands; Jeroen Bosch Hospital, Department of Plastic, Reconstructive, and Hand Surgery, 's-Hertogenbosch, the Netherlands.
| |
Collapse
|
2
|
Lu C, Luo Z, Zeng L, Rao Z, Wang M, Wang X, Xiong H, Zhou B. Research hotspots and trend of wrist arthroscopy: A bibliometrics analysis from 2013 to 2023. Medicine (Baltimore) 2024; 103:e37684. [PMID: 38579032 PMCID: PMC10994499 DOI: 10.1097/md.0000000000037684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 03/01/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Wrist arthroscopy technology is a surgical technology invented in recent years and widely used in clinical treatment of various wrist diseases. This study uses the methods of bibliometrics and visual analysis to understand the global research status, research hotspots, and future development trends of wrist arthroscopy. METHODS The relevant literature of global publications on wrist arthroscopy from 2013 to 2023 was extracted from the Web of Science Core Collection database, and the annual output, cooperation, hot spots, research status, and development trend of this field were analyzed by using the bibliometric software (VOSviewers, CiteSpace, and the R package "Bibliometrix"). RESULTS A total of 635 articles were included, from 2013 to 2023, the number of publications related to wrist arthroscopy showed an overall upward trend, the USA, France, and China are the top 3 countries in terms of the number of publications, whereas Mayo Clinic is the institution with the highest number of publications, Ho PC holds a core position in this field, keyword analysis indicates that the research hotspots are the applications of wrist arthroscopy in triangular fibrocartilage complex injuries, scaphoid nonunion, and avascular necrosis of the lunate. CONCLUSION SUBSECTIONS Wrist arthroscopy has shown tremendous potential in treating various wrist diseases. However, there are still some challenges in its research domain. With continuous deep research, strengthened international collaboration, and ongoing technological advancements, wrist arthroscopy has the potential to become the standard treatment in hand surgery, offering more efficient and safer treatment options for patients worldwide.
Collapse
Affiliation(s)
- Chengyin Lu
- Department of the Second Clinic College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China
- Department of Orthopedics, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, China
| | - Zhiqiang Luo
- Department of the Second Clinic College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Li Zeng
- Department of the Second Clinic College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Zehua Rao
- Department of the Second Clinic College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Mingxuan Wang
- Department of the second Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Xiaohui Wang
- Department of Orthopedics, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang, China
| | - Hui Xiong
- Department of the Second Clinic College of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Biao Zhou
- Department of Orthopedics, The First People’s Hospital of Xiangtan City, Xiangtan, China
- Department of Orthopedics, Wangjing Hospital of Chinese Academy of Chinese Medical Science, Beijing, China
| |
Collapse
|
3
|
Abstract
With advances in the understanding of elbow anatomy, pathologies of the elbow, arthroscopic instrumentation, and surgical techniques over recent decades, elbow arthroscopy has become a valuable treatment modality for a variety of conditions. Elbow arthroscopy has gained utility for treating problems such as septic arthritis, osteoarthritis, synovitis, osteophyte and loose body excision, contracture release, osteochondral defects, select fractures, instability, and lateral epicondylitis. Accordingly, precise knowledge of the neurovascular anatomy, safe arthroscopic portal placement, indications, and potential complications are required to maximize patient outcomes and assist in educating patients. This comprehensive review provides the reader an understanding of the potential complications associated with arthroscopic procedures of the elbow and to describe strategies for prevention and management.
Collapse
|
4
|
Tsenkov T, Dimitrov N. A systematic review of elbow arthroscopy complications : Complications, risk factors, and safety tips. INTERNATIONAL ORTHOPAEDICS 2022; 46:1073-1083. [PMID: 35106672 DOI: 10.1007/s00264-022-05320-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/23/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine the complications from elbow arthroscopy for the past 16 years, and to summarize the most reported safety techniques and risk factors. METHODS Eligibility criteria included level I to IV evidence articles that were published after 2005 in the English language. Excluded were vet, paediatric, and cadaver studies. Open and arthroscopic-assisted elbow procedures were not included. Two online databases were comprehensively searched (PubMed and PMC) in April 2021. Relevant paper selection was conducted by two independent reviewers. MINORS score, demographic properties, indications, procedure type, complication rates, reoperation rates, reported risk factors, and safety techniques were recorded. RESULTS Fifty-two articles met the criteria and were included. No relevant level I to II evidence studies were discovered. The mean age ranged from 31 to 65 years. The average body mass indexes were between 26 and over 40 kg/m2. There was a prevalence of male sex (from 50.2 to 79.2%). Most of the studies reported a minimum follow-up (range, 4 weeks-12 months). The most common arthroscopic procedure was debridement (up to 73% in Leong et al.'s study). The average MINORS score was 12 (range, 10-16). The total complications rate ranged from 1.5 to 11%, with a few studies reporting over 25%. Nerve injury rate was 1.26-7.5%. Re-operation rate ranged from none (100 procedures) to 11.8%. CONCLUSIONS Elbow arthroscopy is a successful procedure with a low overall complications rate (from 1.5 to 11%), and a low nerve injury rate (from 1.26 to 7.5%). Risk factors include patient-related factors (obesity, female sex, age over 65 years, elevated blood sugar levels, hypercoagulable disorder, tobacco and alcohol use), preoperative elbow impairment/previous surgery, and periprocedural steroid injections. Our review discovered a re-operation rate of 2 to 18%.
Collapse
Affiliation(s)
- Tsvetan Tsenkov
- University Hospital of Orthopaedics "Prof. B. Boichev", Medical University of Sofia, 56 Nikola Petkov Blvd., Sofia, 1614, Bulgaria.
| | - Nikolay Dimitrov
- University Hospital of Orthopaedics "Prof. B. Boichev", Medical University of Sofia, 56 Nikola Petkov Blvd., Sofia, 1614, Bulgaria
| |
Collapse
|
5
|
Verdecchia N, Johnson J, Baratz M, Orebaugh S. Neurologic complications in common wrist and hand surgical procedures. Orthop Rev (Pavia) 2018; 10:7355. [PMID: 29770175 PMCID: PMC5937362 DOI: 10.4081/or.2018.7355] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 01/07/2018] [Indexed: 12/21/2022] Open
Abstract
Nerve dysfunction after upper extremity orthopedic surgery is a recognized complication, and may result from a variety of different causes. Hand and wrist surgery require incisions and retraction that necessarily border on small peripheral nerves, which may be difficult to identify and protect with absolute certainty. This article reviews the rates and ranges of reported nerve dysfunction with respect to common surgical interventions for the distal upper extremity, including wrist arthroplasty, wrist arthrodesis, wrist arthroscopy, distal radius open reduction and internal fixation, carpal tunnel release, and thumb carpometacarpal surgery. A relatively large range of neurologic complications is reported, however many of the studies cited involve relatively small numbers of patients, and only rarely are neurologic complications included as primary outcome measures. Knowledge of these neurologic outcomes should help the surgeon to better counsel patients with regard to perioperative risk, as well as provide insight into workup and management of any adverse neurologic outcomes that may arise.
Collapse
Affiliation(s)
| | - Julie Johnson
- Department or Orthopedic Surgery, University of Pittsburgh Medical Center, PA, USA
| | - Mark Baratz
- Department or Orthopedic Surgery, University of Pittsburgh Medical Center, PA, USA
| | | |
Collapse
|
6
|
Abstract
Arthroscopy of the wrist continues to evolve and advance as a valuable clinical technique in hand surgery. This article aims to address safety of wrist arthroscopy and provide an overview of the known iatrogenic complications. Ultimately, the likelihood of associated injuries during wrist arthroscopy is dependent on the surgeon's ability and understanding of the equipment. Case volume and duration of experience directly correlate with mitigating iatrogenic injury and optimizing patient outcomes.
Collapse
|
7
|
Lim JW, Lee YB, Lee JS. Late radio-lunate arthritis following ulnar shortening osteotomy. J Orthop Sci 2017; 22:1142-1145. [PMID: 27192926 DOI: 10.1016/j.jos.2016.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 04/03/2016] [Accepted: 04/20/2016] [Indexed: 02/09/2023]
Affiliation(s)
- Jung-Won Lim
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, School of Medicine, 224-1 Heukseok-dong, Dongjak-gu, Seoul 156-755, South Korea
| | - Yong Beom Lee
- Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, 22, Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do 431-796, South Korea
| | - Jae Sung Lee
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, School of Medicine, 224-1 Heukseok-dong, Dongjak-gu, Seoul 156-755, South Korea.
| |
Collapse
|
8
|
Abstract
The evidence behind management options for midcarpal instability (MCI) is scarce, relying solely on case series. Established treatments cause significant loss of wrist motion. As understanding of the condition has progressed, surgeons have been trying soft tissue techniques. The treatment option should be chosen for the appropriate type and grade of MCI. The Hargreaves grading system for palmar MCI aids treatment decision-making. A possible role for arthroscopy in treatment of MCI has been developed using arthroscopic thermal capsular shrinkage, appropriate for cases with dynamic instabilities. Static deformities require a soft tissue reconstruction or a partial wrist fusion.
Collapse
|
9
|
Arrigoni P, Cucchi D, D'Ambrosi R, Menon A, Aliprandi A, Randelli P. Arthroscopic R-LCL plication for symptomatic minor instability of the lateral elbow (SMILE). Knee Surg Sports Traumatol Arthrosc 2017; 25:2264-2270. [PMID: 28337591 DOI: 10.1007/s00167-017-4531-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/20/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE Minor instability has been proposed as a possible aetiology of lateral elbow pain. This study presents the results of the arthroscopic plication of the radial component of the lateral collateral ligament (R-LCL) to reduce minor instability of the lateral elbow. METHODS Twenty-seven patients with recalcitrant lateral epicondylitis who had failed conservative therapy and who had no previous trauma or overt instability, were included. R-LCL plication was performed in the presence of at least one sign of lateral ligamentous patholaxity and one intra-articular abnormal finding. Single-assessment numeric evaluation (SANE), Oxford Elbow Score (OES), quickDASH (Disabilities of the Arm, Shoulder, Hand), patient satisfaction and post-operative range of motion were evaluated. RESULTS SANE improved from a median of 30 [2-40] points pre-operatively to 90 [80-100] at final follow-up (p < 0.0001), and 96.3% patients obtained good or excellent subjective results. Post-operative median quickDASH was 9.1 [0-25] points and OES 42 [34-48]. Median post-operative flexion was 145°, and extension was 0°. Post-operative flexion was restrained in seven patients and extension in eight patients; 59% of patients reached full ROM at final follow-up. CONCLUSIONS R-LCL plication produces subjective satisfaction and positive clinical results in patients presenting with a symptomatic minor instability of the lateral elbow (SMILE) at 2-year median follow-up. A slight limitation in range of motion is a possible undesired consequence of this intervention. LEVEL OF EVIDENCE Retrospective case series, Level IV.
Collapse
Affiliation(s)
- Paolo Arrigoni
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy.,U.O. Ortopedia II, IRCCS Policlinico San Donato, Piazza Malan 1, 20097 San Donato Milanese, Milan, Italy
| | - Davide Cucchi
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy. .,U.O. Ortopedia II, IRCCS Policlinico San Donato, Piazza Malan 1, 20097 San Donato Milanese, Milan, Italy.
| | - Riccardo D'Ambrosi
- IRCCS Policlinico San Donato, Piazza Malan 1, 20097 San Donato Milanese, Milan, Italy
| | - Alessandra Menon
- IRCCS Policlinico San Donato, Piazza Malan 1, 20097 San Donato Milanese, Milan, Italy
| | - Alberto Aliprandi
- Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 1, 20097, San Donato Milanese, Milan, Italy
| | - Pietro Randelli
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy.,U.O. Ortopedia II, IRCCS Policlinico San Donato, Piazza Malan 1, 20097 San Donato Milanese, Milan, Italy
| |
Collapse
|
10
|
Factors That Increase the Risk of Infection After Elbow Arthroscopy: Analysis of Patient Demographics, Medical Comorbidities, and Steroid Injections in 2,704 Medicare Patients. Arthroscopy 2017; 33:1175-1179. [PMID: 28427874 DOI: 10.1016/j.arthro.2017.02.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 02/01/2017] [Accepted: 02/06/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE To use a national database to determine (1) the incidence of joint infection after elbow arthroscopy, (2) identify independent patient-related risk factors for infection, and (3) determine the influence of concomitant intra-articular corticosteroid injection on infection risk. METHODS The 100% Medicare Standard Analytic Files were queried to identify patients who underwent elbow arthroscopy from 2005 to 2012. Postoperative elbow infections occurring within 6 months of surgery were identified using both International Classification of Diseases, 9th Revision codes for postoperative infection and Current Procedural Terminology codes for the surgical treatment of a postoperative infection. Patients were excluded if their initial arthroscopic procedure was performed for infection. A multivariate binomial logistic regression analysis was then used to evaluate patient-related risk factors for postoperative infection. RESULTS Of the 2,704 elbow arthroscopy cases identified, 42 (1.55%) developed a postoperative infection. The annual incidence of infections did not increase significantly over the course of the study (P = .374). A number of patient demographics and medical comorbidities significantly increased the risk of infection. The most notable factors included age ≥ 65 years (odds ratio [OR] 2.38, P = .006), body mass index > 40 (OR 1.97, P = .024), tobacco usage (OR 1.80, P = .046), alcohol usage (OR 4.01, P < .001), diabetes mellitus (OR 2.10, P = .015), inflammatory arthritis (OR 2.81, P < .001), hypercoagulable disorder (OR 2.51, P = .015), and intra-articular corticosteroid injection at the time of arthroscopy (OR 2.79, P = .006). CONCLUSIONS The annual number of elbow arthroscopies performed in the United States has increased steadily; however, the postoperative infection rate remained consistently low at 1.55%. There are a number of patient-specific risk factors that increase this risk with OR ranging from 1.97 to 4.01. Similarly, patients who receive an intra-articular corticosteroid injection at the time of surgery are nearly 3 times (OR 2.79) more likely to develop a postoperative infection. LEVEL OF EVIDENCE: Level III, case-control study.
Collapse
|
11
|
Scapholunate kinematics of asymptomatic wrists in comparison with symptomatic contralateral wrists using four-dimensional CT examinations: initial clinical experience. Skeletal Radiol 2016; 45:437-46. [PMID: 26659662 DOI: 10.1007/s00256-015-2308-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 11/04/2015] [Accepted: 11/30/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Using four-dimensional CT scan (4DCT), we aimed at showing the kinematics of scapholunate (SL) interval in asymptomatic wrists in comparison with symptomatic contralateral wrists with inconclusive radiographic findings. METHODS This is an IRB approved, HIPPA compliant, retrospective study. Patients suspected of SL interosseous ligament (SLIL) injuries were referred for further evaluation of chronic wrist pain (>3 months). Twelve wrists (11 subjects) with chronic symptoms and inconclusive plain radiographs and 10 asymptomatic wrists (in 10 different subjects) were scanned using 4DCT. The minimum SL interval was measured during three wrist motions: relaxed-to-clenched fist, flexion-to-extension, and radial-to-ulnar-deviation. Changes were recorded using double-oblique multiplanar reformation technique. RESULTS We extracted the normal limits of the SL interval as measured by dynamic CT scanning during active motion in asymptomatic wrists. In asymptomatic wrists, the average SL interval was observed to be smaller than 1 mm during all motions. In symptomatic wrists, during exams performed with clenched fist (SL interval (mean ± SD) = 2.53 ± 1.19 mm), extension (2.54 ± 1.48 mm) or ulnar deviation (2.06 ± 1.12 mm), the average SL interval was more than 2 mm. In contrast to symptomatic wrists, no significant change in SL interval measurements was detected during wrist motions in asymptomatic wrists. There was a mild to moderate correlation between SL interval change and presence/absence of symptoms (point-biserial correlation coefficients: 0.29-0.55). CONCLUSION In patients with wrist pain suspicious for SLIL injury and inconclusive radiographs, SL interval increase can be detected with 4DCT in the symptomatic wrist compared to the asymptomatic wrist.
Collapse
|
12
|
Arrigoni P, D’Ambrosi R, Randelli P. Arthroscopic Treatment of Annular Drive Through and Radial Lateral Collateral Ligament Articular-Side Tear of the Elbow. Arthrosc Tech 2015; 4:e647-50. [PMID: 26870640 PMCID: PMC4738185 DOI: 10.1016/j.eats.2015.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 07/13/2015] [Indexed: 02/03/2023] Open
Abstract
An elongation or partial articular-sided tear of the radial lateral collateral ligament (R-LCL) is a rare injury causing disability and instability of the elbow. In our experience this condition is often associated with a pathologic sign of the annular ligament named the "annular drive through" caused by a redundancy of the ligament. The benefits of performing an arthroscopic procedure for surgical stabilization of the R-LCL include smaller incisions with less soft-tissue dissection, better visualization of the joint, better repair accessibility, and elimination of the annular drive-through sign. The main steps of the operation are as follows: evaluation of annular drive through, inspection of the radial side of the joint, anterior capsulotomy, insertion of a suture anchor through the anterolateral portal, shuttling of the suture anchor through the ligament, and elimination of the annular drive-through sign. By use of this technique, it is possible to repair a lesion of the R-LCL with a suture anchor that ensures an anatomic repair and, at the same time, returns the annular ligament to its physiological tension.
Collapse
Affiliation(s)
| | - Riccardo D’Ambrosi
- IRCCS Policlinico San Donato, Milan, Italy,Università degli Studi di Milano, Milan, Italy,Address correspondence to Riccardo D’Ambrosi, M.D., IRCCS Policlinico San Donato, Piazza Edmondo Malan 1, 20097 San Donato Milanese, Milan, Italy.
| | - Pietro Randelli
- IRCCS Policlinico San Donato, Milan, Italy,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
13
|
Leong NL, Cohen JR, Lord E, Wang JC, McAllister DR, Petrigliano FA. Demographic Trends and Complication Rates in Arthroscopic Elbow Surgery. Arthroscopy 2015; 31:1928-32. [PMID: 25980921 DOI: 10.1016/j.arthro.2015.03.036] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 03/06/2015] [Accepted: 03/19/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate demographic trends in elbow arthroscopy over time, as well as to query complication rates requiring reoperation associated with these procedures. METHODS The Current Procedural Terminology (CPT) billing codes of patients undergoing elbow arthroscopy were searched using a national insurance database. From the years 2007 to 2011, over 20 million orthopaedic patient records were present in the database with an orthopaedic International Classification of Diseases, Ninth Revision diagnosis code or CPT code. Our search for procedures and the corresponding CPT codes for the elbow included diagnostic arthroscopy, loose body removal, synovectomy, and debridement. The type of procedure, date, gender, and region of the country were identified for each patient. In addition, the incidence of reoperation for infection, stiffness, and nerve injury was examined. RESULTS There was a significant increase in arthroscopic elbow procedures over the study period. Male patients accounted for 71% of patients undergoing these procedures. Of the elbow arthroscopy patients, 22% were aged younger than 20 years, 25% were aged 20 to 39 years, 47% were aged 40 to 59 years, and 6% were aged 60 years or older. Other than synovectomy, there were regional variations in the incidence of each procedure type. The overall rate of reoperation was 2.2%, with specific rates of 0.26% for infection, 0.63% for stiffness, and 1.26% for nerve injury. It should be noted that because only the complications requiring reoperation are recorded in the database, these numbers are lower than the overall complication rate. CONCLUSIONS Overall, the incidence of elbow arthroscopy in this patient population is relatively low and appears to be increasing slightly over time. In the database used in this study, elbow arthroscopy procedures were most commonly performed in male patients and in patients aged 40 to 59 years, with regional variation in the incidence of the different procedures. Furthermore, the rate of complications requiring reoperation was low, with a nerve operation being the most common reoperation performed. LEVEL OF EVIDENCE Level IV, therapeutic case series.
Collapse
Affiliation(s)
- Natalie L Leong
- Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California, U.S.A..
| | - Jeremiah R Cohen
- Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California, U.S.A
| | - Elizabeth Lord
- Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California, U.S.A
| | - Jeffrey C Wang
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, California, U.S.A
| | - David R McAllister
- Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California, U.S.A
| | - Frank A Petrigliano
- Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California, U.S.A
| |
Collapse
|
14
|
Carroll MJ, Hildebrand KA. Bilateral pulmonary emboli after elective elbow arthroscopy: a case report. J Shoulder Elbow Surg 2015; 24:e141-3. [PMID: 25769905 DOI: 10.1016/j.jse.2015.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 01/01/2015] [Accepted: 01/03/2015] [Indexed: 02/01/2023]
Affiliation(s)
- Michael J Carroll
- Section of Orthopedic Surgery, Department of Surgery, University of Calgary, Calgary, AB, Canada.
| | - Kevin A Hildebrand
- Section of Orthopedic Surgery, Department of Surgery, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
15
|
|
16
|
|