Preventing Complications in Arthroscopic Surgery

  • Davide Blonna
  • Enrico Bellato


The risk of complications of elbow arthroscopy remains a concern. Regardless the type of positioning, it is important that the surgeon be the one to do it. Proper fluid inflow and outflow is mandatory to prevent the elbow from getting swollen, as swelling can reduce joint visualization and increase the risk of severe complications. Suction has to be avoided while working close to neurological structures. A stepwise technique is the best way to reduce the risk of complications. An accurate knowledge of the anatomy (particularly of the nerves around the elbow) is the basis of proper and safe portal placement. Ulnar nerve decompression helps the surgeon to safely place the anteromedial portals. The use of retractors improves the joint visualization, reduces the length of the procedure, and helps the surgeon to protect neurovascular structures. To reduce extensive hematoma, the use of tranexamic acid at the end of the procedure can be helpful, and post-op drains are usually indicated for 24 h after surgery.


Elbow arthroscopy Safety Fluid management Retractors Portals Neurologic complications 



To Dr Shawn W. O’Driscoll, who has been a patient teacher, who provided time and detailed attention to teaching the authors, and so many more.


  1. 1.
    O’Driscoll SW, Blonna D. Osteocapsular arthroplasty of the elbow: surgical technique. Essential Surgical Techniques. 2013;3:e15 11.Google Scholar
  2. 2.
    Dodson CC, Nho SJ, Williams RJ 3rd, et al. Elbow arthroscopy. J Am Acad Orthop Surg. 2008;16:574–85.CrossRefGoogle Scholar
  3. 3.
    Blonna D, Huffmann GR, O'Driscoll SW. Delayed-onset ulnar neuritis after release of elbow contractures: clinical presentation, pathological findings, and treatment. Am J Sports Med. 2014;42:2113–21.CrossRefGoogle Scholar
  4. 4.
    Blonna D, O'Driscoll SW. Delayed onset ulnar neuritis after release of elbow contracture: preventive strategies derived from a study of 563 cases. Arthroscopy. 2014;30:947–56.CrossRefGoogle Scholar
  5. 5.
    Blonna D, Moriatis Wolf J, Fitzsimmons JS, et al. Prevention of nerve injury during arthroscopic capsulectomy of the elbow utilizing a safety-driven strategy. J Bone Joint Surg Am. 2013;95:1373–81.CrossRefGoogle Scholar

Copyright information

© ISAKOS 2020

Authors and Affiliations

  • Davide Blonna
    • 1
  • Enrico Bellato
    • 2
  1. 1.Department of Orthopedics and TraumatologyMauriziano-Umberto I Hospital, University of Turin Medical SchoolTurinItaly
  2. 2.Department of Orthopedics and TraumatologySan Luigi Gonzaga Hospital, University of Turin Medical SchoolTurinItaly

Personalised recommendations