Olecranon Fossa Fenestration Approach to the Coronoid and Anterior Elbow: The Way OFF

Hypertrophic osteoarthritis of the elbow is a challenging condition that can vary from mild to severe, affecting patients’ quality of life due to pain and loss of range of motion. A consensus about its treatment does not exist. Open arthrolysis with capsular release, synovectomy, Outerbridge-Kashiwagi fenestration, and removal of loose bodies and osteophytes demonstrated good results. In more recent times, an arthroscopic procedure has been shown to have the same efficacy as the open one. The aim of this Technical Note is to describe an all-arthroscopic procedure to reach the coronoid tip, in a safe and reproducible manner, through an olecranon fossa fenestration with a direct transtricipital posterior portal and an anterior cruciate ligament guide.