Purpose
The purpose of this review was to systematically examine the literature surrounding
elbow arthroscopy for pediatric patients and to assess indications, functional outcomes,
and complication rates.
Methods
This systematic review was carried out in accordance with PRISMA guidelines. EMBASE,
PubMed, and MEDLINE were searched for relevant literature from inception until December
2019, and studies were screened by 2 reviewers independently and in duplicate for
those investigating elbow arthroscopy in a pediatric population (<18 years). Editorials,
review articles, and case reports were excluded. Demographic data and data on surgical
indications, treatment outcomes, and complications were recorded. A methodological
quality assessment was performed for all included studies using the Methodological
Index for Non-Randomized Studies.
Results
Overall, 19 studies, all of level IV evidence, were identified with a total of 492
patients (513 elbows). The patient population was 22.3% female with a mean age of
14.0 years (range, 4.0-15.7) and a mean follow-up time of 33.0 months (range, 7.4-96
months). Twelve studies (263 patients) exclusively recruited patients with osteochondritis
dissecans (OCD), although other indications for elbow arthroscopy included arthrofibrosis
(50 patients), elbow fracture (37 patients), medial ulnar collateral ligament injury
(31 patients), and posterior impingement (17 patients). All 13 reporting studies showed
a significant improvement in the elbow flexion-extension arc, and 4 of 5 that reported
a functional outcome score before and after surgery demonstrating a significant improvement.
Last, the overall complication rates ranged from 0% to 23.8%, with a total of 8 instances
of neurological injury (5 ulnar, 2 radial, 1 unspecified), all being transient and
resolving within 3 to 6 months.
Conclusion
Although elbow arthroscopy is primarily being performed for OCD in children and adolescents,
there is evidence surrounding several other potential indications. Case series published
to date have demonstrated significant improvements in functional outcomes and low
rates of major complications.
Level of Evidence
Level IV, systematic review of level IV studies.
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Article Info
Publication History
Published online: February 01, 2021
Accepted:
January 12,
2021
Received:
May 28,
2020
See commentary on page 1971Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
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© 2021 by the Arthroscopy Association of North America
