Elbow Arthroscopy: Set Up, Portals, and Tools for Success

Elbow arthroscopy is a safe and effective tool for the diagnosis and treatment of multiple intra and extra-articular elbow pathologies. However, the elbow's small size, complex three-dimensional anatomy, and proximity to neurovascular structures can make arthroscopic visualization and treatment technically demanding. Complications are uncommon, but include injury to superficial and deep nervous structures, infection, portal site drainage, and compartment syndrome. The safe performance of elbow arthroscopy requires not only an in-depth knowledge of superficial and intra-articular anatomy, but also proper technique. Attention to key set-up components, including, patient positioning, operative and nonoperative arm positioning, arthroscopic instrumentation, arthroscopic pump pressure, and portal placement can facilitate ease of visualization and allow for the prevention of iatrogenic complications. With the appropriate planning, foundation of knowledge, and meticulous surgical technique, elbow arthroscopy can be performed safely and efficiently for a wide range of elbow disorders.