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

Video Transcription

Video Summary

The speaker discusses techniques for elbow arthroscopy in stiff, arthritic elbows, emphasizing that efficient work depends on visualization. Using a cannula helps maintain a consistent path through the capsule, reduces repeated capsular damage from instrument passes, and improves viewing time and efficiency. They recommend the Arthrex Gemini cannula (with retracting “wings”) and mention older small metal cannulas used as dilators for extra working space.<br /><br />A 66-year-old farmer with 20 years of worsening elbow pain and severe motion limits (flexion 110°, extension deficit 40°) has mechanical blocks from osteophytes and large loose bodies seen on X‑ray and CT. The group debates arthroscopic versus open surgery, noting that deformity, prior surgery, or uncertain ulnar nerve location favor open; advanced arthroscopists may still scope select cases. Surgical tips include planning with 3D CT, prioritizing “room with a view,” removing osteophytes methodically, and cautious anterior capsular release to avoid nerves. Realistic outcomes: pain relief and partial motion gains, not a normal elbow.

Asset Caption

Moderator: Benjamin R. Graves, M.D.

Keywords

elbow arthroscopy

stiff arthritic elbow

Arthrex Gemini cannula

osteophyte removal

loose bodies

anterior capsular release