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Elbow arthroscopy

96 citationsUpdated Sep 2026

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Overview

Elbow arthroscopy is an accepted surgical option for treating numerous conditions of the elbow [6]. Advances in equipment, surgical technique, and anatomical understanding have established it as a safe and effective treatment modality for various pathologies [7, 8]. The procedure has evolved from a diagnostic tool to a therapeutic intervention with expanded indications [17]. It is indicated for patients with clear and arthroscopically treatable pathologies performed by an experienced surgeon [23]. Conversely, it is not indicated for patients with an unclear diagnosis or progressive degenerative joint disease [23]. The available evidence supports its use in the management of the majority of conditions where it is currently applied [2].

The most rewarding and successful indication for elbow arthroscopy is the removal of loose bodies [18]. The procedure offers advantages such as decreased surgical morbidity, improved joint visualization, and the ability to address coexisting intra-articular pathologic conditions with minimal soft tissue injury [8, 10]. Elbow arthroscopy is also an appropriate and safe treatment option in children and adolescents, with good and excellent postoperative results [29]. It has applications in the pediatric population with an acceptable safety profile [34]. Pediatric elbow arthroscopy performed by an experienced surgeon using a standardized technique has an acceptable complication rate similar to rates in the previously published literature on elbow arthroscopy in the pediatric and adult populations [31]. However, a significant proportion of pediatric patients who underwent elbow arthroscopy needed subsequent surgery in the following years [31].

Elbow arthroscopy is a relatively safe procedure with a 0.5% rate of major complications when performed in a standardized fashion [4]. In experienced hands, it is a safe modality of treatment for a variety of pathologies [11]. While it is a safe procedure with low complication rates [43], risks cannot be reduced to zero and require careful attention to anatomy, technique, and surgeon experience [27]. Elbow arthroscopy is not without complications and morbidity despite being a minimally invasive procedure and advances made in surgical technique [1]. Complications of elbow arthroscopy are seen in approximately 14% of cases, with most complications being minor [3]. Major complications of elbow arthroscopy occur in 5% of cases and often require repeat surgery [3]. Predominantly low-level evidence studies demonstrate varying complication rates after elbow arthroscopy with a median of 3% and a range of 0%-71% [5]. Predominantly low-level evidence studies demonstrate varying reoperation rates after elbow arthroscopy with a median of 2% and a range of 0%-59% [5]. Based on findings regarding peripheral nerve injury, elbow arthroscopy is a relatively safe procedure [12]. With the rising number of elbow arthroscopies being performed, a rise in complications is foreseen [16].

Anatomy & Pathophysiology

Bony Anatomy

The elbow is a trocho-ginglymoid joint consisting of medial and lateral articulations that provide bony stability [88]. The trochlea articulates with the ulna within the greater sigmoid notch to create the ulnohumeral, hinged, or trochoid portion of the elbow joint [88], which allows for flexion and extension [53]. The capitellum and radial head form the radiocapitellar joint [88], which allows for forearm rotation [53]. The radius is held in close approximation to the ulna at the proximal radioulnar joint by the annular ligament [88]. The radial head is a concave elliptical structure covered with articular cartilage along the radiocapitellar joint and approximately 270° of the articular margin [88]. The trochlea has a 300-degree arc of cartilage [53].

The distal humeral articulation is angled 30° from the longitudinal axis [88]. The axis of rotation is 5° to 7° angulated in the coronal plane to the epicondylar axis, with the medial side more distal than the lateral side [88]. The medial column diverges from the humeral shaft at a 45-degree angle, and the lateral column diverges at a 20-degree angle [53]. The ulna medially bends approximately 8° at 8 cm from the tip of the olecranon [88]. The articulation to the tip of the coronoid is approximately 30° from the long axis of the ulna in the sagittal plane [88]. The olecranon fossa is an oval structure that is wider in the medial to lateral dimension [38].

Kinematics and Load: The normal elbow has a range of motion from 0° to 140° from extension to flexion and 75° and 85° in pronation and supination respectively [36]. A functional arc in each plane is 100° for flexion and extension and forearm rotation [36]. Normal range of elbow flexion/extension is 0 to 150 degrees [91], while normal forearm pronosupination is 80 to 85 degrees in each direction [91]. The functional range of motion is 30 to 130 degrees flexion/extension and 50 degrees pronosupination [91]. The normal valgus carrying angle of the elbow is 5 to 10 degrees for men and 10 to 15 degrees for women [91]. In full extension, 60% of axial load is transmitted through the radiocapitellar joint [91].

Ligamentous Anatomy

Elbow stability is determined by primary and secondary stabilizers [36]. The three primary stabilizers are the ulnohumeral articulation, the medial ulnar collateral ligament (MUCL), and the lateral ulnar collateral ligament (LUCL) complex [36]. Secondary stabilizers include the radiocapitellar articulation, the common flexor tendon, the common extensor tendon, and the joint capsule [36].

The medial collateral ligament (MCL) complex comprises three ligaments: the anterior oblique, the posterior oblique, and the transverse [60]. The anterior oblique ligament is the strongest component of the MCL complex and is the primary stabilizer to valgus stress [60]. It originates on the anterior-inferior edge of the medial epicondyle and inserts on the sublime tubercle of the ulna [60]. The anterior band of the MCL is taut in extension, and the posterior band is tight in flexion [60]. The posterior bundle of the MCL is the primary restraint to valgus stress with the elbow in maximal flexion [91]. Stability in full extension is provided by the MCL, joint capsule, and ulnohumeral articulation [91].

The lateral ulnar collateral ligament (LUCL) complex originates at the geometric center of the radiocapitellar articulation, just distal to the lateral epicondyle [88]. The LUCL origin center is 10.7 mm from the lateral epicondyle and insertion is 3.3 mm from the apex of the supinator crest [87]. The ulnar nerve passes through the cubital tunnel at the medial column of the elbow [53]. The posterior bundle of the MCL forms the floor of the cubital tunnel along the course of the ulnar nerve [59].

Pathophysiology

Elbow dislocations occur when loads placed on structures about the elbow exceed the intrinsic stability provided by anatomic shape and soft-tissue constraints [58]. Posterior dislocations are the most common type of elbow dislocation, resulting from an axial force applied to the extended elbow [58]. Simple elbow dislocations are typically the result of a fall on an outstretched hand involving a valgus, axial, and posterolateral force [139]. Soft tissue injury in simple dislocation is thought to begin on the lateral side with disruption of the lateral collateral ligament (LCL) and proceeds through the capsule to the medial side with the medial collateral ligament (MCL) being injured last [139]. MRI and video studies suggest that complete ligamentous tears are more common on the medial side of the elbow, with lateral ligaments sometimes preserved [139]. The lateral ulnar collateral ligament injury is the cause of recurrent instability following simple elbow dislocation [58].

Valgus extension overload syndrome involves the olecranon being repeatedly and forcefully driven into the olecranon fossa during throwing, exerting shear forces on the medial aspect of the olecranon tip and fossa [37]. The pathoanatomy of valgus extension overload syndrome includes chondrosis, osteophyte development on the posteromedial olecranon and humerus, and loose bodies [37]. Osteoarthritis of the elbow is characterized by osteophyte formation, capsular contracture, and loose bodies, often with relative preservation of the joint space [38]. Osteoarthritis typically involves the radiocapitellar joint articular cartilage preferentially, with relative preservation of the ulnohumeral articular surfaces [38]. Periarticular hypertrophic osteophytes act as a mechanical block at the end ranges of flexion and extension in elbow osteoarthritis [38].

Lateral epicondylitis is an angiofibroblastic hyperplasia of the extensor carpi radialis brevis (ECRB) tendon, a noninflammatory, dysvascular degenerative process caused by repetitive microtrauma [131]. Elbow tendinopathy is a tendon degeneration resulting from continued microtrauma and failed attempts at healing, rather than an inflammatory condition [136]. Osteochondritis dissecans (OCD) of the capitellum is caused by repetitive microtrauma to the vulnerable epiphysis, which has a tenuous blood supply [131]. Repetitive loading of the lateral compartment of the elbow results in subchondral bone degeneration causing cartilage fragmentation in OCD [131].

UCL injury increases radiocapitellar contact pressures and reduces resistance of the elbow to valgus loading [122]. Elbow valgus torque increases contact pressure in the radiocapitellar joint [112]. The olecranon stabilizes valgus stress to the elbow, and excessive resection places the MCL at risk [60]. Valgus torque generated at the elbow during throwing maneuvers is highest in the late cocking and early acceleration phases of throwing [60]. The surrounding elbow musculature, specifically the flexor digitorum superficialis and flexor carpi ulnaris, provide a dynamic stabilizing force across the elbow joint and may be protective of the static restraint of the MCL [60].

Little Leaguer’s elbow is a progressive problem resulting from repetitive microtrauma and shear stresses to the medial elbow at the medial epicondyle physis, ulnar collateral ligament, and flexor pronator origin [140]. Intrinsic causes of elbow stiffness include articular damage or malunion, intraarticular hardware, and loose bodies [128]. Extrinsic causes of elbow stiffness include a contracted joint capsule and ligaments, heterotopic ossification, prominent hardware, and skin contracture [128]. Posttraumatic or postsurgical contractures involve a damaged, abnormally thickened joint capsule and potential for altered anatomy [128]. In posttraumatic or postsurgical stiffness, the joint space is usually contracted and the capsule is scarred down to the bones [128]. Adhesions and scarring in posttraumatic or postsurgical stiffness can make anatomy visually confusing once the joint is entered [128]. The locations of the median and radial nerves may be altered in posttraumatic or postsurgical stiffness due to contracted anterior soft tissues [128].

Classification

Classification of osteochondritis dissecans (OCD) lesions is critical because current management guidelines depend on the type of lesion present and its stability [41]. Most classifications for OCD of the elbow are based on standard radiographs, CT, MRI, or arthroscopy [41]. Lesions can also be classified during the arthroscopic procedure [41].

Minami Classification: The Minami Classification describes grade 1 as a stable lesion with a translucent cystic shadow in the capitellum [41]. Grade 2 is defined by a clear zone between the OCD and adjacent subchondral bone [41]. Grade 3 is characterized by loose bodies [41]. A recent study found the Minami Classification to be the most reliable for classifying different stages of OCD of the capitellum [41]. However, it was unclear whether radiographic evidence categorized by this system guides treatment in clinical practice due to fair agreement [41].

Itsubo et al. Classification: The Itsubo et al. classification, based on MRI, distinguishes five stages [41]. Stage 1 is characterized by a normally shaped capitellum with several spotted areas of high signal intensity [41]. Stage 2 features a normally shaped capitellum with several spotted areas of higher intensity than that of cartilage [41]. Stage 3 is characterized by discontinuity and noncircularity of the chondral surface signal of the capitellum and no high signal interface apparent between the lesion and the bottom of the lesion [41]. Stage 4 is characterized by a lesion separated by a high-intensity line in comparison with the cartilage [41]. Stage 5 is characterized by a capitellar lesion displaced from the floor or a defect of the capitellar lesion [41].

Other Considerations: The value of grading of capitellar OCD seems limited [41]. In a study of primary elbow osteoarthritis, the Kwak classification was used to categorize patients into stage I, II, and III groups [158]. In a study of simple elbow dislocations, osteochondral lesions were staged from I to IV based on MRI findings, with Stage I defined as subchondral edema only and Stage IV defined as a loose body [85].

Clinical Presentation

General Evaluation Principles

A thorough history and physical examination are essential for understanding the disease process and its impact on the patient [133]. The history is the most valuable tool to guide the clinical examination of the elbow [145]. Clinicians must determine the location, quality, type, context, duration, and severity of elbow pain to understand pathology and focus the physical examination [145]. Determining whether pain occurs throughout the arc of motion or only at terminal limits is of paramount importance [133]. Associated mechanical symptoms or instability must be evaluated during the clinical workup [133]. Associated conditions such as cubital tunnel syndrome must be considered and evaluated to provide optimal management recommendations [133]. Prior treatments, including surgical interventions and injections, help in making the correct diagnosis [145]. Determining the symptom trajectory (whether pain is getting better, worse, or remaining constant) is helpful when considering intervention [145]. The physical examination of the elbow is essential to correct diagnosis and should focus on functional anatomy [145]. Adequate elbow assessment is essential for accurate diagnosis and initiating proper treatment [71]. Isolated elbow injuries are rare, and fractures should be interpreted as proxies for associated soft tissue injuries [71].

Imaging

Plain radiographs should be obtained during the initial workup to evaluate the articular surface and bony anatomy [133]. Standard and specialized views of the elbow can provide valuable clinical information during patient evaluation [44]. CT scans with 3D reconstructions may be useful for evaluating the extent and location of disease and for surgical planning [133]. MRI may be useful to evaluate the status of soft tissues, including the medial and lateral collateral ligamentous complexes [133]. Electromyography and nerve conduction studies (EMG/NCS) may be useful to evaluate the degree of nerve compression and its contribution to elbow pain or dysfunction [133].

Osteoarthritis

Patients with primary osteoarthritis of the elbow typically present with loss of terminal extension and flexion [38]. Pain in primary osteoarthritis is typically noted at the end ranges of motion rather than through the midrange [38]. Patients often report painful catching, clicking, or locking of the elbow [38]. Night pain is not typical of primary osteoarthritis; if present, an inflammatory cause should be considered [38]. Forearm rotation is relatively preserved until later in the disease process of primary osteoarthritis [38]. Ulnar neuropathy is present in up to 50% of patients with primary osteoarthritis of the elbow [38]. Radiographs for primary osteoarthritis typically show osteophyte formation at the coronoid process, coronoid fossa, radial fossa, radial head, olecranon tip, and olecranon fossa [38]. Radiographs typically underestimate the number of loose bodies present in primary osteoarthritis of the elbow [38]. CT may be useful for surgical planning and allows a detailed assessment of osteophytes and the presence of loose bodies in primary osteoarthritis [38].

Valgus Extension Overload Syndrome

Patients with valgus extension overload syndrome report posteromedial elbow pain that occurs during the deceleration phase of throwing as the elbow reaches terminal extension [37]. Pain in valgus extension overload syndrome may also occur during the acceleration phase of throwing [37]. Loss of terminal elbow extension may occur in patients with valgus extension overload syndrome [37]. Crepitus and tenderness over the posteromedial olecranon may be noted on physical examination for valgus extension overload syndrome [37]. Pain in valgus extension overload syndrome is reproduced when the elbow is forced into extension [37]. Elbow flexion contracture may be seen in patients with valgus extension overload syndrome [37]. AP, lateral, oblique, and axillary views of the elbow may reveal posteromedial olecranon osteophytes and/or loose bodies in valgus extension overload syndrome [37]. CT with two-dimensional reconstruction and three-dimensional surface rendering best visualizes the pathology of valgus extension overload syndrome [37]. MRI may be most helpful in evaluating associated injuries, including partial or complete tears of the medial collateral ligament, in valgus extension overload syndrome [37].

Medial Collateral Ligament Injuries

Patients with medial collateral ligament (MCL) injuries report medial elbow pain during the acceleration phase of throwing [60]. Pain in MCL injuries may occur only when throwing at more than 50% to 75% of maximal effort [60]. Acute MCL injuries may present suddenly with a pop, sharp pain, and inability to continue throwing [60]. Point tenderness can be noted at the MCL or toward its insertion sites during physical examination [60]. Valgus instability is tested with the patient’s elbow flexed between 20° and 30° to unlock the olecranon from its fossa as valgus stress is applied [60]. The milking maneuver is performed by pulling on the patient’s thumb to create valgus stress while the forearm is supinated and the elbow is flexed beyond 90° [60]. A subjective feeling of apprehension, instability, or localized pain at the MCL during the milking maneuver indicates injury [60]. The moving valgus stress test involves applying valgus stress while the elbow is moved through an arc of flexion or extension [60]. A subjective feeling of apprehension, instability, or localized pain at the MCL during the moving valgus stress test indicates injury [60]. AP, lateral, and axillary views should be obtained to assess for joint space narrowing, osteophytes, and loose bodies in MCL injuries [60]. Valgus stress radiographs with the elbow in 20° to 30° of flexion and the forearm in full supination may be used to measure medial joint line opening [60]. Greater than 3 mm of medial joint line opening on valgus stress radiographs has been considered diagnostic for valgus instability [60]. Conventional MRI can help identify thickening within the ligament from chronic injury or more obvious full-thickness tears in MCL injuries [60]. Magnetic resonance arthrography enhanced with intra-articular gadolinium improves the diagnosis of partial undersurface tears in MCL injuries [60]. Dynamic ultrasonography can help detect increased laxity with valgus stress, but the diagnostic quality of the results is operator dependent [60].

Lateral Elbow Tendinopathy

Patients with lateral elbow tendinopathy report pain when lifting things from a bag with a pronated hand, turning doorknobs, taking milk from the fridge, shaking hands, taking a laptop out of a bag, or bumping the lateral elbow [145]. Direct palpation of the extensor carpi radialis brevis (ECRB) origin is a physical examination maneuver for lateral elbow tendinopathy [145]. The tennis elbow shear test is a physical examination maneuver for lateral elbow tendinopathy [145]. Pain along with resisted wrist or long finger extension is a physical examination finding for lateral elbow tendinopathy [145]. The laptop test is a physical examination maneuver for lateral elbow tendinopathy [145]. MRI is used to evaluate the lateral ulnar collateral ligament (LUCL) if it is suspected as part of the pathology in lateral elbow tendinopathy [145]. Ultrasonography is used to evaluate lateral elbow tendinopathy [145].

Posterolateral Rotatory Instability

Patients with posterolateral rotatory instability report not trusting the elbow [145]. Patients with posterolateral rotatory instability report a feeling of giving way or instability when pushing out of a chair with arms [145]. The posterolateral rotatory (PLR) drawer test is a physical examination maneuver for posterolateral rotatory instability [145]. The PLR pivot shift test is a physical examination maneuver for posterolateral rotatory instability [145]. The supinated push-up test is a physical examination maneuver for posterolateral rotatory instability [145]. MRI is used to evaluate posterolateral rotatory instability [145].

Plica

Patients with a plica report a pop with associated pain that then "feels better" [145]. Direct palpation of a "click" with flexion and pronation is a physical examination maneuver for an anterior plica [145]. Direct palpation of a "click" with extension and supination is a physical examination maneuver for a posterior plica [145]. MRI is used to evaluate a plica [145]. Dynamic ultrasonography is used to evaluate a plica [145].

Trauma (Lateral)

Patients with lateral trauma report a history of an acute traumatic event followed by pain [145]. Direct palpation is a physical examination maneuver for lateral trauma [145]. Pain with pronosupination or flexion and extension is a physical examination finding for lateral trauma [145]. Plain radiographs are used to evaluate lateral trauma [145]. CT with 3D reconstruction is used to evaluate lateral trauma [145].

Radiocapitellar Arthrosis

Patients with radiocapitellar arthrosis report a history of distant trauma or surgery [145]. The radiocapitellar (RC) load test, which involves pain with pronation and resisted extension, is a physical examination maneuver for radiocapitellar arthrosis [145]. CT with 3D reconstruction is used to evaluate radiocapitellar arthrosis [145].

Osteochondritis Dissecans (OCD) or Osteonecrosis

Patients with OCD or osteonecrosis report a gradual loss of motion with or without pain [145]. Patients with OCD or osteonecrosis may report catching and locking if loose bodies are present [145]. The radiocapitellar (RC) load test, which involves pain with pronation and resisted extension, is a physical examination maneuver for OCD or osteonecrosis [145]. CT with 3D reconstruction is used to evaluate OCD or osteonecrosis [145]. MRI is used to evaluate OCD or osteonecrosis [145].

Partial Biceps Tendon Tear

Patients with a partial biceps tendon tear report pain in the lateral arm with resisted supination [145]. Direct palpation of the radial tuberosity with the arm in pronation elicits crepitus and pain in patients with a partial biceps tendon tear [145]. MRI or ultrasonography is used to evaluate a partial biceps tendon tear [145].

Medial Elbow Tendiopathy or Tendon Tear

Patients with medial elbow tendiopathy or tendon tear report pain when washing the face or carrying objects with the arm in a supinated position [145]. Direct palpation of the flexor and pronator tendon origin is a physical examination maneuver for medial elbow tendiopathy or tendon tear [145]. The face press examination is a physical examination maneuver for medial elbow tendiopathy or tendon tear [145]. The server tray examination is a physical examination maneuver for medial elbow tendiopathy or tendon tear [145]. Resisted flexion test is a physical examination maneuver for medial elbow tendiopathy or tendon tear [145]. The moving valgus test, which involves pain between 30° and 60° flexion, is a physical examination maneuver for medial elbow tendiopathy or tendon tear [145]. MRI or ultrasonography is used to evaluate medial elbow tendiopathy or tendon tear [145].

Snapping Triceps

Patients with snapping triceps report pain with flexion accompanied by a pop or snap [145]. Patients with snapping triceps may report tingling into the fingers if the ulnar nerve is involved [145]. Palpation with flexion is a physical examination maneuver for snapping triceps [145]. Ultrasonography is used to evaluate snapping triceps [145].

Ulnar Neuritis or Neuropathy

Patients with ulnar neuritis or neuropathy report that the ring and small fingers go to sleep when the elbow is flexed, such as while reading in bed or waking them up at night [145]. Direct palpation or Tinel test is a physical examination maneuver for ulnar neuritis or neuropathy [145]. Ultrasonography or MRI is used to evaluate ulnar neuritis or neuropathy [145].

MUCL Strain, Tear, or Instability

Athletes with medial ulnar collateral ligament (MUCL) strain, tear, or instability report decreased control and velocity while pitching [145]. Patients with MUCL strain, tear, or instability may have a history of trauma and dislocation [145]. The milking maneuver is a physical examination maneuver for MUCL strain, tear, or instability [145]. The moving valgus stress test is a physical examination maneuver for MUCL strain, tear, or instability [145]. MRI is used to evaluate MUCL strain, tear, or instability [145].

Varus Posteromedial Rotatory Instability

Patients with varus posteromedial rotatory instability report decreased range of motion after a traumatic dislocation with continued varus deformity [145]. Patients with varus posteromedial rotatory instability report pain with activities with the arm away from the body [145]. The gravity-assisted varus grind test is a physical examination maneuver for varus posteromedial rotatory instability [145]. CT with 3D reconstruction is used to evaluate varus posteromedial rotatory instability [145].

Ulnohumeral Arthritis

Patients with ulnohumeral arthritis report a history of inflammatory conditions or trauma [145]. Patients with ulnohumeral arthritis report painful range of motion through the midarc with or without a load [145]. Radiographs or CT with 3D reconstruction are used to evaluate ulnohumeral arthritis [145].

Trauma (Medial)

Patients with medial trauma report a history of trauma [145]. Direct palpation is a physical examination maneuver for medial trauma [145]. Valgus stress and the moving valgus stress test are physical examination maneuvers for medial trauma [145]. Radiographs or CT with 3D reconstruction are used to evaluate medial trauma [145].

Median Nerve Compression

Patients with median nerve compression report vague forearm pain that may radiate from the hand to the forearm [145]. Palpation or Tinel test is a physical examination maneuver for median nerve compression [145]. Ultrasonography or EMG is used to evaluate median nerve compression [145].

Investigations

Plain radiography: Plain radiographs remain the hallmark and best screening test for elbow evaluation [36]. Standard and specialized views provide valuable clinical information during patient evaluation [44].

CT: Computed tomography is helpful for assessing malunion architecture and the location and pattern of osteophytes or loose bodies [59]. Three-dimensional CT is used to check for heterotopic ossification [59]. CT is not necessary when elbow stiffness is entirely soft-tissue related [59].

MRI: Magnetic resonance imaging is the modality best suited for evaluating soft-tissue structures in the elbow, including ligaments, tendons, cartilage, and nerves [97]. While MRI can evaluate ligaments and tendons, it is rarely indicated for elbow stiffness [59]. Magnetic resonance arthrography is particularly beneficial in the evaluation of osteochondral lesions, loose bodies, and ulnar collateral ligament injury in a throwing athlete [97].

Arthroscopy: Elbow arthroscopy has significant diagnostic value in radial head fractures when compared to standard radiological imaging [124]. It revealed concomitant injuries in patients with uneventful MRI or CT for radial head fractures [124]. Three reproducible arthroscopic techniques are valuable in identifying and quantifying elbow instability [14]. Patients treated arthroscopically benefit from additional diagnostic techniques and improved visualization of the elbow joint [10]. Arthroscopy allows for the management of soft tissue lesions and associated intra-articular bone or cartilage lesions with minimal disruption in the setting of elbow instability [42]. The Minami Classification was the most reliable for classifying different stages of osteochondritis dissecans of the capitellum [41]. Diagnostic and therapeutic procedures in the elbow can be performed using needle arthroscopy with direct in-line visualization [52].

Physical Examination: The physical exam is directed by history and the location of the patient's pain in the anterior, posterior, medial, or lateral aspect of the elbow [36]. A complete neurovascular examination of the radial, median, ulnar, and anterior and posterior interosseous nerves should be done before and after treatment [53]. An assessment for ulnar nerve subluxation should be performed during the evaluation of elbow stiffness [59]. Subluxation of the ulnar nerve is a relative contraindication for an arthroscopic procedure secondary to possible iatrogenic nerve injury [59]. If the elbow has less than 90° to 100° of flexion, the posterior bundle of the medial collateral ligament is contracted and must be released to restore flexion [59].

Electrodiagnostics: Electromyography and nerve conduction velocity studies should be performed if any question about neurologic dysfunction exists in the evaluation of elbow stiffness [59].

Other Considerations: Severe contracture and periarticular heterotopic ossification are contraindications for arthroscopic procedures in elbow osteoarthritis [38]. Prior ulnar nerve transposition and prior extensive open procedures are relative contraindications for arthroscopic procedures in elbow osteoarthritis [38]. MCL insufficiency is a relative contraindication for isolated olecranon débridement in valgus extension overload syndrome [37].

Treatment

Non-Operative

The provided evidence does not detail specific conservative management protocols such as weight loss, physical therapy, NSAIDs, or injections. However, arthroscopic elbow capsular release is indicated for patients who have residual symptoms from their underlying disease despite prior treatment [45].

Operative

Indications: Elbow arthroscopy has evolved from a diagnostic tool to a therapeutic procedure with expanded indications, requiring careful patient selection and attention to surgical anatomy to avoid neurovascular complications [17]. The procedure is most successful for removing loose bodies [9]. It is also indicated for chronic elbow instability, where it offers improved visualization and the ability to address coexisting intra-articular pathologic conditions with minimal soft tissue injury [10]. Recent advances in instrumentation have increased interest in treating elbow osteoarthritis [39]. Arthroscopic arthrolysis is effective for elbow stiffness, with patients achieving satisfactory clinical outcomes very early postoperatively [26]. Additionally, arthroscopic extensor carpi radialis brevis muscle resection is a technique for chronic elbow lateral epicondylitis that requires familiarity with arthroscopic surgery and experience in elbow arthroscopy [63].

Surgical Approach / Technique: Elbow arthroscopy is a reliable procedure that requires a clear understanding of anatomy to safely access the joint [20]. It can be performed safely with appropriate knowledge of articular and periarticular anatomy, precise surgical technique, and an understanding of the procedure's limitations [19]. The procedure offers advantages including less scarring, decreased risk of infection, less postoperative pain, decreased surgical morbidity, and improved joint visualization [8, 40]. Patient positioning is based primarily on surgeon preference [142]. The modified supine position suspends the arm over the chest with the elbow in 90° of flexion, facilitating access to both anterior and posterior compartments and decreasing the risk of injury to anterior neurovascular structures by allowing them to drop away from the anterior capsule [142]. The lateral decubitus position provides improved arm stability, posterior elbow access, and relatively easy airway management [142]. The prone position provides natural traction, easy access to the posterior compartment, and a theoretically increased space between vascular structures and the anterior capsule [142]. A mechanical forearm holder maintains the elbow joint in any desired degree of extension or flexion without the need for an assistant [78]. An inexpensive support device provides excellent support and stability with excellent proximal and distal access [81]. A new setup for elbow arthroscopy reduces operative time, facilitates easy training and triangulation, and has no additional risks compared with conventional setup [98]. When properly executed, the procedure is safe and efficient with minimal risk to patients [101].

Implant Selection: Ulnar collateral ligament reconstruction using a suspension button fixation technique reliably restores elbow kinematics to the intact state [68]. An all-arthroscopic reconstruction of the lateral ulnar collateral ligament is reproducible and achieves reconstruction of the LUCL while avoiding residual instability [150]. Arthroscopic fragment fixation using absorbable pins is effective for osteochondritis dissecans of the humeral capitellum [141].

Other Considerations: Arthroscopic identification of Baker lesions helps confirm the presence of pathology commonly seen intra-articularly in patients with lateral epicondylitis, although no statistical relation between Baker lesion severity and postoperative outcomes or nonoperative management success has been published [51]. Arthroscopic elbow arthrolysis via posterior and posterolateral approaches with humeral fenestration is safe and effective for elbow stiffness [156]. Elbow arthroscopy is not necessarily contraindicated in patients with a subluxating or transposed ulnar nerve [116]. Neither the procedure nor the use of the proximal anteromedial portal is contraindicated in patients with prior transposition or subluxation of the ulnar nerve [117]. Arthroscopic extra-articular ulnar nerve release is applicable to posteromedial elbow pathology by two medial portals [86]. Arthroscopic ulnar nerve identification during posterior elbow arthroscopy allows for safer performance of procedures in the posteromedial region [95].

Complications and Outcomes: Complications occur in approximately 14% of cases, with most being minor and major complications occurring in 5% of cases, often requiring repeat surgery [3]. Predominantly low-level evidence studies demonstrate varying complication rates (median 3%, range 0%-71%) and reoperation rates (median 2%, range 0%-59%) [5]. The majority of neurologic complications are transient [25]. Bilateral pulmonary emboli are a rare but potentially serious complication [24].

Pediatric Population: Pediatric elbow arthroscopy performed by an experienced surgeon using a standardized technique has an acceptable complication rate similar to rates in the previously published literature on elbow arthroscopy in the pediatric and adult populations [31]. Pediatric patients who underwent elbow arthroscopy had an 86% return-to-sport rate, a 12% reoperation rate, and a 3.7% complication rate [31].

Operative Setup and Positioning: Operative extremity landmarks should be mapped out before insufflation, as distension can alter position [152]. Approximately 25 to 30 mL of arthroscopy fluid is injected into the joint space until resistance is met [152]. The superomedial viewing portal is located 3 cm proximal to the medial epicondyle and anterior to the intermuscular septum [152]. The median nerve and brachial artery are approximately 12.4 and 18.0 mm away from the superomedial portal, respectively [152]. The proximal anterolateral portal is placed approximately 2 cm proximal to the lateral epicondyle and directly anterior to the humerus [152]. This portal is safe, out of the direct pathway of the radial nerve and approximately 6 mm from the posterior antebrachial cutaneous nerve [152]. A dedicated inflow cannula is important to control flow and decrease fluid utilization in small-bore needle arthroscopy of the elbow [52].

Evidence Level: The majority of the top 50 cited articles in elbow arthroscopy comprised case series exhibiting Level IV or V evidence [15].

Complications

Overall Complication Rates: Elbow arthroscopy is generally considered a safe procedure with low complication rates [43], though risks cannot be reduced to zero [27]. Despite being minimally invasive, the procedure is associated with morbidity [1]. Reported overall complication rates vary widely, with systematic review data demonstrating a median rate of 3% (range 0%-71%) [5]. Other reports cite an overall rate of approximately 14% [3], while historical data indicate rates as high as 20% [82]. In a standardized fashion, the major complication rate is 0.5% [4], compared to 5% in other series where major complications often require repeat surgery [3]. The median reoperation rate is 2% (range 0%-59%) [5]. In pediatric populations, experienced surgeons using standardized techniques report a 3.7% complication rate and a 12% reoperation rate [31]. Overall complication rates are lower following arthroscopic approaches compared to open approaches [166]. Notably, novice portal placement is associated with a surgical complication rate of 30% [168].

Neurovascular Complications: Neurovascular injury is the most common complication of elbow arthroscopy, resulting from surgeon inexperience, poor technique, and lack of anatomical knowledge [82]. The prevalence of neurologic injury ranges from 1.7% to 10.4% [109]. Most injuries are transient and resolve without residual deficit [82, 109], with transient nerve injury rates ranging from 1.7% to 2.0% [82]. However, major nerve injuries are not rare and are likely under-reported in the literature [171]. Permanent nerve injury is rare but carries lifelong consequences [109]. Common insults include compression from cannulas, fluid extravasation, local anesthesia, and laceration with scalpel or cannula [82]. Obesity is associated with significantly increased rates of nerve injury in Medicare patients [121].

Infection: The overall infection rate after elbow arthroscopy is 1.55% in Medicare patients [99]. Deep infection was the most common complication in a 30-day postoperative profile, occurring in 3 of 530 cases (0.57%) [113]. Several factors significantly increase postoperative infection risk: intraoperative intra-articular corticosteroid injection [173], preoperative corticosteroid injection within 4 weeks of surgery [173], obesity (BMI >30) [173], diabetes [173], and tobacco smoking [173]. An increased risk of postoperative infection was also noted in patients receiving an intra-articular steroid injection at the end of the procedure [82]. Obesity is associated with significantly increased rates of infection in Medicare patients [121].

Stiffness / Arthrofibrosis: Obesity is associated with significantly increased rates of stiffness after elbow arthroscopy in Medicare patients [121].

Other Considerations: Heterotopic ossification (HO) is a minor complication with a prevalence of 6.3%, usually located on the medial compartment [83]. Other known complications include articular cartilage injury, synovial fistula formation, instrument breakage, and tissue injury secondary to tourniquet use [82]. A significant proportion of patients visited the emergency department at least once within 90 days following surgery [21]. No substantial association exists between complication rate and surgical complexity for procedures including complete synovectomy, radial head resection, osteocapsular arthroplasty, and medial epicondylectomy [82]. Obesity is associated with significantly increased rates of medical complications in Medicare patients [121]. Life-changing complications such as deep infection and permanent nerve injury do occur [169].

Recovery

Complications and Safety Profile: Most complications following elbow arthroscopy are minor [3]. Major complications occur in 5% of cases and often require repeat surgery [3]. Systematic review data indicate a median complication rate of 3% (range 0% to 71%) and a median reoperation rate of 2% (range 0% to 59%) [5]. A significant proportion of patients visit the emergency department at least once in the 90 days following the procedure [21]. Symptomatic bilateral pulmonary emboli are a rare but potentially serious complication of elective elbow arthroscopy [24]. The incidence of nerve injury has not changed over 30 years and is unlikely to be eliminated [148].

Functional Outcomes and Range of Motion: Arthroscopic circumferential release provides safe and effective restoration of range of motion, pain relief, and functional improvement in patients with posttraumatic elbow stiffness regardless of preoperative severity [170]. In patients with primary elbow osteoarthritis undergoing arthroscopic osteocapsular arthroplasty, clinical outcomes improved from preoperative assessment to short- and medium-term follow-up, although range of motion decreased between short- and medium-term follow-up [146]. Patients saw improvement in elbow range of motion after arthroscopic elbow capsular release, though many had residual symptoms from their underlying disease [45]. Arthroscopic elbow contracture release can improve function and range of motion, with outcomes varying based on preoperative patient characteristics [49]. Arthroscopic debridement for primary degenerative osteoarthritis leads to a statistically significant and clinically relevant improvement in both elbow extension and flexion [35]. Arthroscopic treatment of lateral epicondylitis is associated with optimized long-term outcomes due to minimal disruption of superficial extensors [70]. Arthroscopic management of elbow instability promotes quicker patient recovery and long-term functional restoration [46]. Triceps tendon-guided arthroscopic olecranon debridement can restore adequate joint space, mobility, and function to patients with degenerative elbow osteoarthritis [75]. Professional baseball players saw an improvement in several performance metrics after elbow arthroscopy [164].

Key Evidence

• [L3] Elbow arthroscopy is not without complications and morbidity despite being a minimally invasive procedure and advances made in surgical technique. [1] (10.1177/17585732241249393)
• [L4] The available evidence supports the use of elbow arthroscopy in the management of the majority of conditions where it is currently used. [2] (10.1016/j.arthro.2011.10.007)
• [L4] Complications of elbow arthroscopy are seen in approximately 14% of cases, with most being minor and major complications occurring in 5% of cases, often requiring repeat surgery. [3] (10.1016/j.jse.2013.09.026)
• [L4] Elbow arthroscopy is a relatively safe procedure with a 0.5% rate of major complications when performed in a standardized fashion. [4] (10.1016/j.jse.2013.01.032)
• [L4] 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. [5] (10.1016/j.arthro.2023.04.015)
• [L5] Elbow arthroscopy has become an accepted surgical option for treating numerous conditions of the elbow. [6] (10.1016/j.jhsa.2012.10.023)
• [L5] Elbow arthroscopy has become a safer and more effective treatment modality for several elbow pathologies due to advances in equipment and surgical technique. [7] (10.5435/00124635-200810000-00003)
• [L5] Diagnostic and surgical arthroscopy of the elbow has become an accepted treatment modality for numerous conditions, most successful for removing loose bodies. [9] (10.5435/00124635-200605000-00007)
• [L4] Patients treated arthroscopically benefit from additional diagnostic techniques, improved visualization of the elbow joint, the ability to address coexisting intra-articular pathologic conditions, and minimal soft tissue injury with no clinical consequences in outcomes. [10] (10.1016/j.arthro.2013.08.016)
• [L4] In experienced hands, elbow arthroscopy is a safe modality of treatment for a variety of pathologies. [11] (10.1016/j.arthro.2007.03.081)
• [L4] Based on these findings, we conclude that elbow arthroscopy is a relatively safe procedure. [12] (10.1016/j.arthro.2017.12.004)
• [Paper] The authors present 3 reproducible arthroscopic techniques that are valuable in identifying and quantifying elbow instability. [14] (10.1016/j.eats.2023.04.029)
• [L4] The majority of the top 50 cited articles in elbow arthroscopy comprised case series exhibiting Level IV or V evidence. [15] (10.1016/j.jisako.2024.04.011)
• [L5] The authors suggest that with the rising number of elbow arthroscopies being performed, a rise in complications is foreseen. [16] (10.5312/wjo.v8.i2.99)
• [L5] Elbow arthroscopy has evolved from a diagnostic tool to a therapeutic procedure with expanded indications, though it requires careful attention to surgical anatomy and patient selection to avoid neurovascular complications. [17] (10.1177/03635465990270022401)
• [L4] Elbow arthroscopy has become a safe and effective treatment option for a number of elbow disorders, with the most rewarding and successful indication being the removal of loose bodies. [18] (10.2152/jmi.61.233)
• [L5] Elbow arthroscopy can be performed safely with appropriate knowledge of the articular and periarticular anatomy, precise surgical technique, and understanding of the procedure's limitations. [19] (10.1136/jisakos-2016-000089)
• [L5] Elbow arthroscopy is a reliable procedure that requires a clear understanding of the anatomy to be able to safely access the joint. [20] (10.1016/j.arthro.2019.05.014)
• [L3] A significant proportion of patients from a large cohort of elbow arthroscopy patients visited the ED at least once in the 90 days following surgery. [21] (10.1016/j.jseint.2024.03.015)
• [L4] Elbow arthroscopy is indicated for patients with clear and arthroscopically treatable pathologies performed by an experienced surgeon, but is not indicated for patients with an unclear diagnosis or progressive degenerative joint disease. [23] (10.1007/s004020050237)
• [Case_report] This report highlights a rare but potentially serious complication of elbow surgery, specifically symptomatic bilateral pulmonary emboli after elective elbow arthroscopy. [24] (10.1016/j.jse.2015.01.002)
• [L2] Furthermore, the majority of neurologic complications following elbow arthroscopy are transient. [25] (10.1016/j.arthro.2020.12.134)
• [L1] Patients with stiff elbows who underwent arthroscopic arthrolysis achieved satisfactory clinical outcomes very early postoperatively. [26] (10.1016/j.jse.2024.06.009)
• [L5] Elbow arthroscopy is a safe procedure with a low complication rate, but risks cannot be reduced to zero and require careful attention to anatomy, technique, and surgeon experience. [27] (10.1016/j.arthro.2020.03.030)
• [L4] Elbow arthroscopy is an appropriate and safe treatment option in children and adolescents with good and excellent postoperative results. [29] (10.1186/s40001-018-0338-5)
• [L4] Pediatric elbow arthroscopy performed by an experienced surgeon using a standardized technique for a wide variety of elbow conditions has an acceptable complication rate that is similar to rates in the previously published literature on elbow arthroscopy in the pediatric and adult populations; however, a significant proportion of patients needed subsequent surgery in the following years. [31] (10.1016/j.asmr.2024.100952)
• [L4] Elbow arthroscopy has applications in the pediatric population with an acceptable safety profile. [34] (10.1016/j.jse.2017.07.005)
• [L1] [35] (10.1016/j.arthro.2017.08.247)
• [L5] Recent advances in arthroscopic instrumentation and techniques have led to growing interest in arthroscopic treatment of elbow osteoarthritis. [39] (10.1016/j.jhsa.2017.05.023)
• [L5] Arthroscopy is emerging as an invaluable tool for diagnosing and treating elbow pathology, offering advantages such as less scarring, decreased risk of infection, and less postoperative pain. [40] (10.1016/j.hcl.2009.05.009)
• [L5] [41] (10.1136/jisakos-2015-000008)
• [L5] Elbow arthroscopy has become a valid and safe option for the diagnosis and treatment of both acute and chronic elbow instability, allowing for the management of soft tissue lesions and associated intra-articular bone or cartilage lesions with minimal disruption. [42] (10.1016/j.jseint.2022.12.001)
• [L4] Elbow arthroscopy is a safe procedure with low complication rates. [43] (10.1016/j.arthro.2019.11.108)
• [L5] Standard and specialized views of the elbow can be very beneficial and, when used appropriately, will provide valuable clinical information during the evaluation of patients. [44] (10.1016/j.jhsa.2014.04.035)
• [L4] Overall, patients saw improvement in elbow ROM, but many still had residual symptoms from their underlying disease after arthroscopic elbow capsular release. [45] (10.1177/23259671231190381)
• [L5] This minimally invasive method allows effective management of elbow instability while promoting quicker patient recovery and long-term functional restoration. [46] (10.1016/j.eats.2025.103529)
• [L4] Arthroscopic elbow contracture release can improve function and range of motion; however, outcomes may vary based on preoperative patient characteristics. [49] (10.1016/j.jseint.2026.101621)
• [L4] [51] (10.1016/j.eats.2024.103142)
• [Paper] The authors describe an approach for diagnostic and therapeutic procedures in the elbow using needle arthroscopy, detailing portal locations for direct in-line visualization and the importance of a dedicated inflow cannula to control flow and decrease fluid utilization. [52] (10.1016/j.eats.2020.07.013)
• [L5] However, this method requires familiarity with arthroscopic surgery and experience in elbow arthroscopy. [63] (10.1016/j.eats.2023.07.017)
• [L5] Ulnar collateral ligament reconstruction using a suspension button fixation technique reliably restored elbow kinematics to the intact state. [68] (10.1177/0363546509350109)
• [L5] The authors favor arthroscopic treatment for surgeons with elbow arthroscopy training due to the ability to address concomitant intra-articular pathologies and minimal disruption of superficial extensors, leading to optimized long-term outcomes. [70] (10.1016/j.arthro.2022.10.004)
• [L5] Adequate elbow assessment is essential for accurate diagnosis and initiating proper treatment, as isolated elbow injuries are rare and fractures should be interpreted as proxies for associated soft tissue injuries. [71] (10.1016/j.jhsa.2014.04.028)
• [L5] In doing so, we present a reproducible technique that can restore adequate joint space, mobility, and function to the patient with degenerative elbow osteoarthritis. [75] (10.1016/j.eats.2024.103332)
• [L5] This technique simply and reproducibly provides an effective means to temporarily or permanently maintain the elbow joint in any desired degree of extension or flexion during elbow arthroscopy without the need for an assistant. [78] (10.1016/j.eats.2024.102991)
• [Paper] This device provides excellent support and stability to the elbow during arthroscopy and open procedures with excellent proximal and distal access. [81] (10.1016/j.eats.2017.05.022)
• [L4] Among 205 patients who underwent elbow arthroscopy, HO was a minor complication of elbow arthroscopy, with a prevalence rate of 6.3%, and was usually located on the medial compartment of the elbow. [83] (10.1177/03635465231198862)
• [L3] [85] (10.1177/2325967120946269)
• [L4] The authors present a surgical technique applicable to posteromedial elbow pathology by 2 medial portals. [86] (10.1016/j.eats.2024.103062)
• [Paper] The described technique translates the open surgery philosophy of identifying neurovasculature to arthroscopy, allowing for safer performance of procedures in the posteromedial region of the elbow. [95] (10.1016/j.eats.2012.05.002)
• [Paper] The technique reduces operative time, facilitates easy training and triangulation, and has no additional risks compared with conventional elbow arthroscopy setup. [98] (10.1016/j.eats.2012.11.003)
• [L3] [99] (10.1016/j.arthro.2017.02.004)
• [Paper] When properly executed, elbow arthroscopy can be performed in a safe and efficient manner with minimal risk to patients. [101] (10.1016/j.eats.2016.08.022)
• [L4] [109] (10.1007/s00167-017-4719-z)
• [L5] Elbow valgus torque increases contact pressure in the radiocapitellar joint. [112] (10.1177/0363546513490652)
• [L4] [113] (10.1016/j.arthro.2017.08.286)
• [L4] Elbow arthroscopy is not necessarily contraindicated in patients with a subluxating or transposed ulnar nerve. [116] (10.1016/j.arthro.2009.04.024)
• [L4] Neither elbow arthroscopy nor specifically the use of the proximal anteromedial portal is contraindicated in patients with prior transposition or subluxation of the ulnar nerve. [117] (10.1016/j.arthro.2009.12.029)
• [L3] [121] (10.1016/j.arthro.2015.08.025)
• [L5] UCL injury increases radiocapitellar contact pressures and reduces resistance of the elbow to valgus loading. [122] (10.1016/j.jse.2010.09.011)
• [L4] Elbow arthroscopy has a significant diagnostic value in radial head fractures when compared to standard radiological imaging and revealed concomitant injuries even in patients with uneventful MRI/CT. [124] (10.1186/s12891-019-2726-6)
• [L4] This arthroscopic procedure, performed with the elbow in the maximum flexed position using posterolateral and lateral portals and absorbable pins, is effective for fragment fixation. [141] (10.1007/s00167-009-0945-3)
• [L4] Serial assessment of patients with primary elbow OA who underwent arthroscopic OCA showed that the clinical outcomes improved from preoperative assessment to short- and medium-term follow-up, although ROM decreased between short- and medium-term follow-up. [146] (10.1177/23259671231162398)
• [L5] The incidence of nerve injury in elbow arthroscopy has not changed over 30 years, is unlikely to be eliminated, and can be used to honestly counsel patients. [148] (10.1016/j.arthro.2018.01.033)
• [L5] The presented arthroscopic technique is reproducible and achieves the reconstruction of the LUCL of the elbow as well as avoids residual instability. [150] (10.1016/j.eats.2024.103096)
• [L5] [152] (10.1016/j.eats.2025.103463)
• [L4] [156] (10.1016/j.asmr.2024.101029)
• [L3] [158] (10.1016/j.jse.2023.05.041)
• [L3] After elbow arthroscopy, professional baseball players saw an improvement in several performance metrics. [164] (10.1177/03635465261424876)
• [L3] Overall rates of complication were lower following arthroscopic approaches in this cohort of surgeons. [166] (10.1177/23259671261425647)
• [L5] A surgical complication rate of 30% was found with novice portal placement during elbow arthroscopy. [168] (10.1007/s00167-016-4186-y)
• [L5] Elbow arthroscopy is mostly safe and effective, but life-changing complications such as deep infection and permanent nerve injury do occur; surgeons must strive to minimize patient exposure to these events by mastering indications, anatomy, and technique. [169] (10.1016/j.arthro.2023.06.011)
• [L3] Arthroscopic circumferential release provides safe and effective restoration of ROM, pain relief, and functional improvement in patients with posttraumatic elbow stiffness, regardless of preoperative severity. [170] (10.1177/23259671261450556)
• [L4] Major nerve injuries after elbow arthroscopy are not rare occurrences and the risk is likely under-reported in the literature. [171] (10.1016/j.arthro.2015.11.023)
• [L3] Significant increases in postoperative infection risk in patients who underwent arthroscopy of the ankle, knee, hip, shoulder, and elbow were noted with intraoperative intra-articular CSI administration or preoperative CSI administration within 4 weeks of surgery, BMI >30, diabetes, and smoking tobacco. [173] (10.1177/03635465261429468)

See Also

• Elbow Osteoarthritis
• Cubital Tunnel Syndrome
• Tennis Elbow
• Elbow Instability
• Osteochondritis Dissecans of the Capitellum

References

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[122] The impact of ulnar collateral ligament tear and reconstruction on contact pressures in the lateral compartment of the elbow. Journal of Shoulder and Elbow Surgery. 2011. DOI: 10.1016/j.jse.2010.09.011

[124] The value of elbow arthroscopy in diagnosing and treatment of radial head fractures. BMC Musculoskeletal Disorders. 2019. DOI: 10.1186/s12891-019-2726-6

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[152] Basics of Elbow Arthroscopy. Arthroscopy Techniques. 2025. DOI: 10.1016/j.eats.2025.103463

[156] Anterior Capsulectomy Through Humeral Fenestration in Arthroscopic Arthrolysis for Elbow Stiffness Is Safe and Effective. Arthroscopy, Sports Medicine, and Rehabilitation. 2024. DOI: 10.1016/j.asmr.2024.101029

[158] Radiologically severe osteoarthritis is related to worse clinical outcomes after arthroscopic osteocapsular arthroplasty in primary elbow osteoarthritis at medium-term follow-up: a retrospective cohort study. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2023.05.041

[164] Elbow Arthroscopy and the Risk of Future Ulnar Collateral Ligament Surgery in Professional Baseball Pitchers. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261424876

[166] Arthroscopic Versus Open Elbow Debridements Among ABOS Part II Candidates: A Decline in Arthroscopic Volume yet Fewer Complications After Arthroscopic Procedures. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671261425647

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[169] Editorial Commentary: Avoiding Complications in Elbow Arthroscopy: Know the Indications, Learn the Anatomy, and Master a Safe Technique. Arthroscopy. 2023. DOI: 10.1016/j.arthro.2023.06.011

[170] Serial Comparison of Clinical Outcomes After Arthroscopic Circumferential Release for Severe and Nonsevere Posttraumatic Elbow Stiffness. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671261450556

[171] Major Peripheral Nerve Injuries After Elbow Arthroscopy. Arthroscopy. 2016. DOI: 10.1016/j.arthro.2015.11.023

[173] Risk Factors for Infection After Ankle, Knee, Hip, Shoulder, or Elbow Arthroscopy: A Systematic Review and Meta-analysis. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261429468