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Elbow Arthroscopy

INTRODUCTION

The elbow joint is a hinged joint where the upper arm bone (humerus) meets the two forearm bones (ulna and radius). The main stabilizing structure of the elbow joint is the ligament along the inner aspect of the elbow (medial collateral ligament.) The unique anatomy of the elbow joint allows it to pass through a broad range of motion. During repetitive overhead and lifting sports and occupations, the elbow experiences tremendous stress. This may lead to the formation of small loose fragments of cartilage or bone (loose bodies) or elbow joint spurs.

Arthroscopic surgery of the elbow is challenging because of the joint's anatomy. The bones lie close together, and nerves and blood vessels are located very close to the joint (see illustration). Therefore, the doctor must be especially careful when inserting the arthroscopic instruments into the joint.

Although it is a difficult procedure, arthroscopic surgery is often the ideal choice for treating certain elbow conditions. An injury or arthritis can damage the ends of the bones and cause bone spurs to develop. These spurs can be painful and make it hard to move the elbow. The doctor can remove the spurs by using special tools, such as a burr, inserted into the joint through the portals or small incisions. After the spurs are removed, the elbow moves more easily and with less pain.

THE OPERATION

An elbow arthroscopy introduces an arthroscope (small 'telescope') into the elbow joint through several small 2-3 millimeter incisions.
The arthroscope is used to identify the location of the loose bodies and the spurs.
The loose bodies can be removed by using the arthroscope in addition to small grasping instruments. The bone spurs can be removed by visualizing the spur with the arthroscope and using a small burr to remove the spur.
These elbow arthroscopic procedures take about 30-90 minutes and are done on an day-case basis (without an overnight stay in the hospital).

Elbow Arthroscopy with Loose Body

 
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Removal of Loose Body

(click on the image to see a video clip)
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copyright Primal Pictures Ltd

GENERAL ADVICE

You should not eat or drink anything after midnight the night before the procedure.

You will usually only be in hospital for a day.
A doctor/physiotherapist will see you before you go home. You will be given exercises to do immediately after the procedure. These exercises are an essential part of your recovery.

Outpatient physiotherapy should be arranged before you leave the hospital.

You can return to work as soon as you feel able and driving is usually possible after two weeks. Most patients return to work within several days, but if their job requires heavy lifting, climbing or throwing return may be delayed several weeks. Full recovery and return to pre-injury athletic activities occurs within 3-6 weeks for loose body removal and 8-12 weeks for elbow spur removal.


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