Description
Introduction. This study is aimed to assess and quantify the improvement in visualization of humeral insertion of medial collateral ligament (MCL) using a 70° scope instead of traditional 30° scope during elbow arthroscopy.
Methods and Material. 20 patients undergoing elbow arthroscopy for different pathologic conditions were enrolled in this single-center study. Visualization of the medial gutter of the elbow was evaluated by using both the 70° and the 30°scope. During the procedure, a needle was inserted at 45° in respect to the axis of the forearm, directed towards the intra-articular humeral emergence of the MCL. Four areas were established: the body (Z1), the lanceolate part (Z2), the tip of the needle(Z3) and the medial portion of the trochlea(Z4) (FIG 1). The visible areas during arthroscopy using two different scopes were collected.
Results. The 70° scope allowed the detection of the first three areas in all patients (Z1, Z2 and Z3) and the visualization of the last area (Z4) in 19 patients (95%). On the other hand, the 30° scope allowed the detection of Z1 in 85% patients, of Z2 60% patients, and Z3 in only 5% patient. The medial portion of the trochlea was never visualized with the 30° scope. These findings were statistically significant (FIG 2).
Conclusions. 70°-scope improve visualization of the medial elbow compartment during elbow arthroscopy compared to the 30° scope, enhancing the extent of joint visualization and potentially permitting the detection of otherwise missed injuries in the difficult-to-reach areas of the joint.
