Table 2.

Advantages and Disadvantages of Arthroscopic Medial Bi-portal Extra-articular Debridement Technique

Advantages

All procedures are performed under visualization, and the magnified lesion tissue can be conveniently identified and excised under arthroscopy.

Arthroscopic treatment of recalcitrant medial epicondylitis has the advantages of reducing incision length and scar, relieving postoperative pain, reducing the probability of elbow infection and ankylosis, and having a fast recovery time.

By these two portals the type IIA medial epicondylitis according to the Nirschl classification in which combined with minimal ulnar neuropathy could also be released under arthroscopy. Type IIB medial epicondylitis combined with moderate or severe ulnar neuropathy should be treated with open release and transposition of the ulnar nerve, so the arthroscopic procedure is not suitable for type IIB medial epicondylitis.

Surgeons can visually release the ulnar nerve, making surgery more safe, efficient, and accurate.

Disadvantages

There is a high cost of arthroscopic equipment, in addition to a long learning curve for doctors.

Compared with open surgery, arthroscopic surgery takes a longer preparation time.

Elbow arthroscopy is appropriate for the management of medial epicondylitis combined with mild ulnar neuropathy but not for severe ulnar neuropathy.

To prevent ischemia of the affected limb, the tourniquet time should preferably not exceed 90 min.

A physician lacking anatomic knowledge and clinical experience may cause an iatrogenic injury in an attempt to locate the ulnar nerve.