2019 ISAKOS Biennial Congress Paper #59
Clinical Outcome of Arthroscopic Treatment for Posteromedial Elbow Impingement in Adolescent Baseball Players
Toshiyuki Iwame, MD, Tokushima JAPAN
Tetsuya Matsuura, MD, PhD, Tokushima JAPAN
Naoto Suzue, MD, PhD, Komatsushima, Tokushima JAPAN
Joji Iwase, MD, Tokushima City JAPAN
Shunsuke Tamaki, MD, Kannonji JAPAN
Kenji Yokoyama, MD, Tokushima JAPAN
Koichi Sairyo, MD, PhD, Kawasaki, Kanagawa JAPAN
Tokushima University, Tokushima, JAPAN
FDA Status Not Applicable
Summary
Arthroscopic debridement, excision of the olecranon spur, and removal of fragments yield reliable subjective and objective results and allow a return to baseball in adolescent patients.
Abstract
Purpose
To evaluate the clinical outcomes of arthroscopic treatment in adolescent baseball players with posteromedial elbow impingement.
Methods
This retrospective study evaluated the clinical outcome of arthroscopic treatment for posteromedial elbow impingement in adolescent baseball players. Patients were eligible for participation if they had undergone surgery at least 2 years earlier and excluded if they had arthritis, loose bodies, osteochondritis dissecans, ulnar collateral ligament tear, flexor/pronator mass or medial epicondylitis, or nerve problems. Patients were also excluded if they had undergone prior elbow surgery, were younger than 13 years, or were older than 19 years. Arthroscopic treatment included debridement of posteromedial synovitis, fragment removal, and olecranon spur excision. At a mean follow-up of 26.7 (range 24-42) months, patients were evaluated based on a questionnaire, examination, and their previously reported elbow outcome score.
Results
This retrospective study involved 15 male patients, comprising 6 pitchers, 3 catchers, and 6 fielders, of mean age 15.7 (range 14-17) years. Mean time from onset of symptoms to surgery was 4.9 (range 3-18) months. Intraoperative findings included posteromedial synovitis and olecranon spurs in all patients and fragments in 10. The elbow outcome score was considered excellent in 11 patients and good in 2, with a mean score of 92 points (maximum 100 points). The mean postoperative range of motion at the elbow was 5° to 139.7° of flexion. All patients were able to return to their previous level of play after an average of 3.4 (range 2.5-4.5) months. No patient developed medial instability that later required reconstructive surgery.
Conclusions
Posteromedial elbow impingement is a source of disability in adolescent baseball players. Arthroscopic debridement, excision of the olecranon spur, and removal of fragments yield reliable subjective and objective results and allow a return to baseball in adolescent patients.