APEX Elbow Mastering Surgical Techniques for Clinical Success-Elbow OA, Stiffness

Video Transcription

Video Summary

The speaker discusses techniques and tools that improve visualization and efficiency in elbow arthroscopy, emphasizing that good visualization is essential and cannulas help preserve the capsule and maintain a consistent working channel. They mention preferred cannulas (e.g., Arthrex Gemini with retracting “wings”) and using small metal cannulas as dilators to gain a few millimeters of space.<br /><br />A complex case is presented: a 66-year-old farmer with 20 years of worsening elbow pain and stiffness, mechanical blocks in flexion/extension (110° flexion, 40° extension loss), and imaging showing large osteophytes and loose bodies (“kissing lesions”). The panel debates open vs arthroscopic treatment, noting surgeon experience, anatomy, prior surgery, and ulnar nerve location as key factors; beginners should avoid such cases.<br /><br />The speaker demonstrates anterior debridement/osteophyte removal and discusses sequencing (often leaving loose bodies until later), portal placement, use of CT/3D recon and fluoroscopy, and careful anterior capsular release while avoiding nerve-risk “fat stripes.” Realistic ROM expectations are stressed.

Asset Caption

Moderator: Benjamin R. Graves, M.D.

Keywords

elbow arthroscopy visualization

arthroscopic cannulas Arthrex Gemini

anterior elbow debridement osteophyte removal

elbow loose bodies kissing lesions

anterior capsular release nerve injury avoidance

open versus arthroscopic elbow treatment decision