Elbow Arthroscopy

What is Elbow Arthroscopy?

Elbow arthroscopy, also called keyhole or minimally invasive elbow surgery, is a surgical procedure used to diagnose and treat various conditions affecting the elbow joint. It involves the insertion of a small camera, called an arthroscope, through small incisions in the skin to visualise the inside of the elbow joint. This allows the surgeon to assess and treat any abnormalities present.

Who is Suitable for Elbow Arthroscopy?

Elbow arthroscopy is suitable for individuals who experience elbow pain or have specific conditions that can be addressed through this procedure. Some of the conditions that can be treated with elbow arthroscopy include:

• Loose bodies: Small bone or cartilage fragments within the joint.
• Tennis elbow (lateral epicondylitis): Inflammation of the tendons on the outside of the elbow.
• Golfer's elbow (medial epicondylitis): Inflammation of the tendons on the inside of the elbow.
• Elbow arthritis: Degenerative joint disease affecting the elbow.
• Elbow stiffness: Limited range of motion in the elbow.
• Elbow fractures: Certain types of fractures that can be managed arthroscopically.
• Elbow instability: Recurrent dislocations or subluxations of the elbow joint.

What are the Benefits of Elbow Arthroscopy?

The benefits of elbow arthroscopy include the following:

• Minimally invasive: The procedure requires only small incisions, resulting in less trauma to the surrounding tissues.
• Reduced pain: Smaller incisions result in less postoperative pain than traditional open surgery.
• Faster recovery: The minimally invasive procedure may allow quicker healing than open procedures and a faster return to normal activities.
• Diagnostic and therapeutic: Elbow arthroscopy serves both diagnostic and treatment purposes, enabling the surgeon to identify the problem within the joint and address it during the same procedure.
• Lower complication rates: With proper technique, elbow arthroscopy has a lower complication risk than open surgery.

Types of Elbow Arthroscopy

Several types of elbow arthroscopy procedures exist depending on the specific condition being treated. Some common types include:

• Debridement: Removal of damaged or inflamed tissue, loose bodies, or cartilage fragments from the joint.
• Synovectomy: Removal of the synovial tissue (lining of the joint) in cases of synovitis or rheumatoid arthritis.
• Osteochondritis dissecans (OCD) treatment: Repair or removal of loose bone or cartilage fragments in the elbow joint.
• Ligament reconstruction: Reconstruction of damaged or torn ligaments in cases of elbow instability.
• Fracture fixation: Fixation of certain types of elbow fractures using arthroscopic techniques.

Alternative Options to Elbow Arthroscopy

In some cases, conservative treatments may be considered before resorting to surgery. These options can include:

• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or pain relievers may be prescribed to manage symptoms such as pain and inflammation.
• Physical therapy: A structured exercise program can help improve the elbow joint's range of motion and strength of supporting muscles.
• Rest and activity modification: Avoiding activities aggravating the condition and allowing the elbow to rest can sometimes promote healing.
• Brace or splint: Wearing a brace or splint may help immobilise the elbow and alleviate symptoms.

What to Do Before an Elbow Arthroscopy?

Before undergoing elbow arthroscopy, several steps need to be taken:

• You will have a consultation with an orthopaedic surgeon who will assess your condition, review your medical history, and may order additional tests or imaging studies to determine the appropriate treatment.
• The surgeon or their team will provide specific instructions on fasting, medication use, and necessary preparations before the procedure.
• You might have an individual consultation with an anaesthetist to discuss the anaesthesia options, potential risks and address any concerns.

Elbow Arthroscopy Procedure

Arthroscopy is a surgical procedure in which an arthroscope, a small tube with a light and video camera at the end, is inserted into a joint to evaluate and treat various conditions.

During elbow arthroscopy, the general steps involved are as follows:

• You will be given either general anaesthesia, where you are asleep, or regional anaesthesia, where the area around the elbow is numbed.
• The surgeon makes small incisions around the elbow and inserts the arthroscope, a thin camera, to visualise the joint.
• The surgeon examines the inside of the elbow joint, identifies the problem, and performs the necessary procedures, such as removing loose bodies, repairing ligaments, or removing damaged tissue.
• At the end of the procedure, the incisions are typically closed with sutures or adhesive strips, and a sterile dressing is applied.

What to Expect After an Elbow Arthroscopy?

After elbow arthroscopy, you will be taken to a recovery area, where the medical staff will monitor you and ensure you are stable.

Postoperative Care for Elbow Arthroscopy

The recovery plan after elbow arthroscopy typically includes the following:

• Pain medication may be prescribed to manage postoperative pain. It's important to take the medication as directed by your surgeon.
• Depending on the specific procedure and the surgeon's preference, you may need to initially wear a splint, cast, or brace to immobilise the elbow joint. This helps protect the joint and promote healing.
• Your surgeon may recommend a structured physical therapy program to regain the elbow joint's range of motion, strength and function. The therapy may include exercises, manual therapy, and other modalities tailored to your needs.
• You must follow your surgeon's instructions regarding restrictions and modifications in activities. This may involve avoiding certain movements or sports that could stress or strain the healing elbow joint.
• Regular follow-up appointments will be scheduled with your surgeon to monitor your progress.

Elbow Arthroscopy Prognosis

The prognosis after elbow arthroscopy depends on various factors, including the specific condition being treated, the extent of the problem, and individual factors, such as overall health and compliance with rehabilitation.

In general, elbow arthroscopy has a good prognosis, with many patients experiencing reduced pain, improved range of motion, and restoration of elbow joint function. However, it's important to note that each case is unique, and outcomes can vary.

Elbow Arthroscopy Risks

While elbow arthroscopy is generally considered safe, there are potential risks and complications associated with the procedure, including:

• Infection: There is a small risk of infection at the incision sites or within the joint.
• Bleeding: Excessive bleeding during or after the procedure is possible, although rare.
• Nerve or blood vessel injury: There is a slight risk of injury to nerves or blood vessels around the elbow joint.
• Stiffness or persistent pain: Some patients may experience persistent stiffness or pain in the elbow joint after the procedure.
• Blood clots: Rarely, blood clots can develop in the arm's veins (deep vein thrombosis).
• Anaesthetic complications: Risks associated with anaesthesia, such as adverse reactions or breathing difficulties, are possible.

It's essential to discuss the risks and potential complications with your surgeon before undergoing elbow arthroscopy.