Elbow Arthroscopy is a minimally invasive surgery performed using a tiny device called arthroscope.
The elbow is the joint that connects the upper arm bone and the forearm bones. The elbow joint helps in movement of the arms forward, backward, as well as to twist the arms inside and outside. The elbow joint may get affected by inflammation, injury, or other disease conditions causing severe pain and requiring surgical treatment.
Conditions of the elbow that can be treated by elbow arthroscopy include:
Your surgeon performs medical physical examination and seeks your medical history before arthroscopy is performed.
Elbow arthroscopy is a minimally invasive surgery or keyhole procedure that allows your surgeon to look inside the elbow using small incisions and instruments to evaluate and treat elbow conditions. It is performed under anesthesia.
At first, your surgeon makes 2-3 incisions near your elbow one for insertion of an arthroscope, a small device with a camera and lens fixed to the end of a narrow fiber-optic tube and other for insertion of operating instruments. The camera-lens setting magnifies and projects images of the elbow on a large screen monitor. Through the other incisions surgical instruments are inserted to treat the condition. Your surgeon injects a sterile solution into the elbow to expand the joint that allows giving an extra room to work.
Your joint surfaces are inspected and any problems identified and managed accordingly.
After the surgery the stitches are closed and dressing is applied.
After the surgery, your surgeon will place a cast or a splint that prevents the movement of the elbow until it is healed completely. You should elevate the elbow to avoid swelling and minimize pain. Ice (wrapped over a cloth) can be applied over the operated area which helps to reduce swelling. Medications are prescribed to reduce pain. Always keep the operated area dry and clean.
Some of the advantages of elbow arthroscopy are:
- it requires smaller incisions
- minimal soft tissue trauma
- less pain
- faster recovery time
- low infection rate
- less scarring
- earlier mobilization
- allows patient to restore to normal activities faster.
Some of the risks observed after elbow arthroscopy include:
- damage to the nearby nerves or tissues during surgery
- stiffness, which can usually be treated through occupational therapy.
Nerve injury is slightly more common after keyhole surgery to the elbow, although this is normally a temporary problem. The nerves that cross your elbow pass close to the entry points for the Arthroscope and surgical instruments. The way Mr Granville-Chapman accesses and operates within your elbow is designed to minimize the risk of nerve injury. However, injury to nerves may still occur.
The ulna nerve passes just behind the inside knuckle (medial epicondyle) of your elbow. Permanent injury is very rare, but temporary altered sensation in your little and ring finger can occasionally occur. If the nerve is injured more severely it could also produce weakness of grip in your hand.
The posterior interosseous nerve is a motor nerve that supplies many of your forearm and finger muscles. It runs within a muscle very close to your elbow and is potentially vulnerable. Again, permanent injury is very rare, but if it were to happen, this could cause significant weakness in your wrist and hand that might require reconstructive surgery.
Infection is rare after elbow arthroscopy (<1%)
What is my recovery after elbow arthroscopy?
This is normally a day case procedure. You may take down your bulky bandages after 3 days, but please keep your wounds dressed for 14 days. You can shower after 4 days with your dressings on. Please begin your painkillers as soon as you get home and continue them regularly for the first few days. Unless told otherwise, you can begin gentle elbow motion the day after your surgery and discard the sling when comfortable.
You will be seen two weeks after surgery and thereafter according to your needs.
Return to work and normality will vary depending on what’s been done in your elbow and your own pace of recovery. As a minimum, you should plan 2 weeks off work and driving, but you may require longer.
Exercises are performed to strengthen and rebuild elbow strength.
Elbow arthroscopy may not be performed in individuals with ulnar nerve transposition and in those who had surgery earlier that had changed the normal elbow anatomy.