Arthroscopy and Endoscopy of the Elbow, Wrist and Hand: Surgical Anatomy and Techniques

1122 Pages·2021·143.016 MB·English

by  Deepak N. Bhatia (editor), Gregory I. Bain (editor), Gary G. Poehling (editor), Benjamin R. Graves (editor)

Deepak N. Bhatia
Gregory I. Bain
Gary G. Poehling
Benjamin R. Graves
Editors
Arthroscopy and
Endoscopy of the
Elbow, Wrist and Hand
Surgical Anatomy and Techniques
Arthroscopy and Endoscopy of the
Elbow, Wrist and Hand
Deepak N. Bhatia • Gregory I. Bain
Gary G. Poehling • Benjamin R. Graves
Editors
Arthroscopy and
Endoscopy of the Elbow,
Wrist and Hand
Surgical Anatomy and Techniques
Editors
Deepak N. Bhatia Gregory I. Bain
Department of Orthopaedic Surgery Department of Orthopaedic Surgery
Sir HN Reliance Foundation Hospital Flinders University
and Research Center Adelaide, SA
Mumbai Australia
India
Benjamin R. Graves
Gary G. Poehling Department of Orthopaedic Surgery
Department of Orthopaedic Surgery Wake Forest School of Medicine
Wake Forest School of Medicine Winston-Salem, NC
Winston-Salem, NC USA
USA
ISBN 978-3-030-79422-4 ISBN 978-3-030-79423-1 (eBook)
https://doi.org/10.1007/978-3-030-79423-1
© ISAKOS 2022
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I dedicate this book to my teachers and mentors: The surgeon-
scientists who believed in and taught an evidence based
approach to innovation.
To my parents, Naveen and Rajkumari, and my family, Shilpa
and Shraayan: Gratitude, for the love and encouragement all
along.
Deepak N. Bhatia
Chairman, Elbow, Wrist, and Hand Committee, ISAKOS
I dedicate this book to the aspiring young who……dream to
make a difference, develop a discipline to learn, and devote
themselves to discovering the new dawn. We trust that you will
be dedicated to and inspired by the next generation, just as our
teachers were.
Gregory I. Bain
In loving memory of my wife Sandy, whose support and
encouragement will be cherished always.
Gary G. Poehling
To my wife Jennifer and daughter Lily - your love, support, and
friendship mean everything to me.
Benjamin R. Graves
Foreword
Minimally invasive surgery has become the current standard of care for many,
if not most, surgical procedures. From cataracts to coronary arteries, from
gall bladders to gynecology, minimally invasive surgery has supplanted
Arnold K. Henry’s Extensile Exposure [1] for surgical access to internal ana-
tomic structures. In orthopedics, arthroscopy is expanding minimally inva-
sive surgical techniques from major joints to smaller joints and even to
potential spaces between tissue planes. Standards of care are an evolutionary
concept. Surgical arthroscopy and a touch of bravado helped grow the broad
shoulders of pioneering giants on which we stand today to advance the field
of upper extremity joint surgery.
This work you are holding is a comprehensive textbook of today’s
approaches to elbow, wrist, and hand joint procedures. It contains, in addi-
tion, some trailblazing initiatives that may become tomorrow’s conventional
wisdom in upper extremity joint surgery. The contributing chapter authors
represent global leaders in joint surgery, selected for their expertise and their
support of ISAKOS. While journal articles are giving way to online “how-to”
videos in surgical education, they are no substitute for personal medical
libraries of classic, published articles and comprehensive textbooks for refer-
ence citation and review. This book traces upper extremity minimally inva-
sive joint surgery from its historical origins to its present techniques to its
potential future. It describes the insightful understanding of joint pathology
and pathomechanics and the creative imagination that have brought newer
surgical potentials to reality. The many chapter authors collectively have cre-
ated both a timely and timeless reference text for upper extremity surgeons.
The scriptural Book of Proverbs, written principally by Solomon who
arguably was one of the wisest of men and philosophers, entreats us to seek
wisdom and, with wisdom, understanding (Proverbs 4:5-8). This textbook
offers both—wisdom and understanding—with respect to the spectrum of
joint pathology in the elbow, the wrist, and the hand. The surgical techniques
are complemented with excellent, illustrative graphics and anatomic dissec-
tions. Moreover, the surgical technique discussions include the all-sanguine
“why” to elucidate the advantages of newer surgical approaches to orthopedic
treatments, whether they be diagnostic, reparative, or reconstructive.
While some of the procedures described are perhaps not yet standards of
care, they are sufficiently detailed to serve as instructive reference for the next
stage of advancement in surgical treatments. Thus, this book is wonderfully
instructive, more than a primer in upper extremity arthroscopy but also a
vii
viii Foreword
stimulus for those inclined to read tomorrow’s crystal ball and devise new and
even greater surgical innovations.
I commend all the authors’ courage in compiling this elegant textbook on
upper extremity, minimally invasive joint surgery. It can be read with enjoy-
ment, for deep wisdom and understanding.
Terry L. Whipple
Lifetime Honourary President
International Wrist Arthroscopy Society
Paris, France
Reference
1. Henry, AK, Extensile Exposure. E & S Livingstone Ltd, Edinburgh. 1945
and 1957
Preface
ISAKOS Elbow Wrist and Hand Committee
The EWH committee is a relatively new subspecialist committee in
ISAKOS. The EWH committee was formed in 2015 and the aim was to foster
growth of EWH surgery and arthroscopy. Subspecialist member surgeons
were selected from the global ISAKOS membership with Prof Gregory I.
Bain as the chair. The EWH committee has since conducted ICLs at the
ISAKOS biannual congress, facilitated lectures, JISAKOS publications and
provided ISAKOS books. In 2017, ISAKOS and the EWH committee initi-
ated the Gary G. Poehling Award for the best EWH research paper presented
at an ISAKOS conference. The current committee (2019–2021) took charge
at the ISAKOS conference at Cancun, Mexico, and proposed the book titled
Arthroscopy and Endoscopy of the Elbow, Wrist, and Hand that would
encompass the most progressive and modern techniques, ranging from basic
to advanced.
Aim of the Book
Arthroscopic surgery of the EWH has undergone a paradigm shift in the last
decade and several procedures which were considered “experimental” are
now routinely performed. Arthroscopy has advanced beyond the confines of
the joint, with soft-tissue endoscopy emerging as a minimally invasive solu-
tion to extraarticular pathology. This book brings together basic and advanced
techniques that would be useful to surgeons and trainees at all levels of exper-
tise. Surgical anatomy is the foundation for safe reproducibility of any new
surgical technique, and this aspect has been emphasized using cadaveric dis-
sections, arthroscopic images, and illustrations. Many of the techniques have
been written by the innovator surgeons and those who have extensive experi-
ence with these procedures. The book also features some previously unpub-
lished techniques that will appear here for the first time.
ix
x Preface
Organization and Content
The book begins with an interesting description of historical aspects of
arthroscopy and especially wrist arthroscopy.
The technical content is segregated into three parts: elbow, wrist, and
hand. Each part has subsections beginning with the basic science that forms
the foundation of these techniques. The procedures are subdivided according
to the pathology (instability, fractures, etc.) or grouped by the region within
the anatomical area (distal biceps, ulnar nerve, TFCC, carpometacarpal joint,
etc.). Arthroscopic and endoscopic procedures for specific pathological con-
ditions are described under each of these sections. Each chapter includes a
brief background and key surgical anatomy pertaining to the technique. The
surgical technique is simplified into a “step-by-step” approach with technical
tips, pitfalls, and rehabilitations guidelines. A few open surgical techniques
have been included specifically due to their “gold-standard” position in cur-
rent treatment algorithms and also to highlight regional anatomical details.
Evolving endoscopic techniques have been grouped as a separate subsection
in each part.
The book concludes with chapters on guidelines for incorporating newer
techniques into practice, and the editors’ perspective on the future of elbow,
wrist, hand arthroscopy, and endoscopy.
Acknowledgments
This book was written at a time of a global healthcare crisis and many con-
tributors to this book are involved in the battle against the pandemic. We are
thankful to every contributor for the remarkable dedication to their academic
and educational commitments.
Massimiliano Crespi from Italy was the illustrator for the book. Max has
provided 184 anatomical and surgical illustrations. The illustrations were
supported by a generous grant from ISAKOS.
Mumbai, India Deepak N. Bhatia
Adelaide, Australia Gregory I. Bain
Winston-Salem, USA Gary G. Poehling
Winston-Salem, USA Benjamin R. Graves
Contents
Part I History
1 The Early Development of Arthroscopy . . . . . . . . . . . . . . . . . . . 3
Andrew Baker, Terry L. Whipple, Gary G. Poehling,
and Gregory I. Bain
2 History of Wrist Arthroscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Andrew Baker, Terry L. Whipple, Gary G. Poehling,
and Gregory I. Bain
Part II E lbow: Basic Science
3 Clinical Anatomy of the Elbow . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Gregory I. Bain, Benjamin Seah Renyi, and Janak A. Mehta
4 Elbow Anatomy: A Layered Approach . . . . . . . . . . . . . . . . . . . . 63
Deepak N. Bhatia
5 Surgical Anatomy of the Nerves Around the Elbow . . . . . . . . . 79
Celli Andrea, Serafini Fabio, Peruzzi Marco, and Pederzini
Luigi Adriano
6 Arthroscopic Equipment and Set-Up for Elbow Arthroscopy . . . 89
Richard S. Page, Janina Henze, and Kevin Eng
7 Portals and Technique for Diagnostic Elbow Arthroscopy . . . . 97
Benjamin R. Graves, Michael T. Freehill, Gary G. Poehling,
and Gregory I. Bain
8 Transarticular Posterolateral Portal for Elbow Arthroscopy . . . 109
Minoo Patel
9 Dry Elbow Arthroscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Benjamin Seah Renyi, Joideep Phadnis, and Gregory I. Bain
Part III E lbow: Instability
10 Classification of Elbow Instability . . . . . . . . . . . . . . . . . . . . . . . . 119
Alessandro Marinelli, Enrico Guerra,
Marco Cavallo, Alice Ritali, and Roberto Rotini
xi