Arthroscopic management of miscellaneous elbow disorders

Surgical arthroscopy is indicated primarily in the treatment of radiocapitellar disorders and soft tissue disorders, or bony ankylosis of the elbow joint. However, there are other elbow conditions in which the arthroscope is beneficial, particularly by the treatment of lateral epicondylitis and olecranon bursitis. Chronic lateral epicondylitis can result in damage to the common origin of the extensor carpi radialis brevis muscle. Lesions range from microtears to attenuation and tearing or rupture of the tendon. The damage has been classified arthroscopically into the following three types: type I consists of inflammation and fraying, type II consists of linear tears of the undersurface of the extensor carpi radialis brevis tendon, and type III is an avulsion of the tendon and overlying capsule. Operative treatment involves debriding the diseased capsule and releasing of the tendinous origin of extensor carpi radialis brevis muscle and decorticating the lateral epicondyle. Clinical results of this technique are encouraging. Direct trauma is the most common cause of olecranon bursitis, but it can also be caused by infection or inflammation. Although best managed nonoperatively, the condition may require surgical intervention. The arthroscope is used to excise the olecranon bursa and examine the olecranon tip for spurs. Early results of this procedure have also been encouraging with no major complications or infections.