What is Elbow Arthroscopy?
A surgery called elbow arthroscopy is used to identify and address issues inside the elbow joint. Arthroscopy allows medical professionals to view the anatomy of the elbow in great detail. In contrast to conventional (open) surgery, elbow arthroscopy operations can also cure symptoms and restore elbow function with fewer incisions, less discomfort, and a quicker recovery.
Orthopaedic surgeon perform an arthroscopy treatment to see into a joint and treat issues there. A tiny camera called an arthroscope is inserted into your elbow joint during elbow arthroscopy by your doctor. Your surgeon uses the images from the camera to direct tiny surgical instruments on a television screen.
Your surgeon can do arthroscopic surgery with much smaller incisions than they would need to perform open surgery since the arthroscope and surgical equipment are thin. Patients experience less pain, as a result, have less joint stiffness, and their recovery times to resume favourite activities are frequently shortened.
Since the 1980s, elbow arthroscopies have been carried out. It has accelerated what was long thought to be impossible in terms of access to diagnosis, treatment, and post-operative rehabilitation. Every year, elbow arthroscopy advances thanks to the creation of new tools and procedures.
When Elbow Arthroscopy is Prefered?
A diagnostic procedure for pain, stiffness, and loss of joint motion is elbow arthroscopy.
Among the more widespread diagnoses are
- Adhesions and soft tissue bands that restrict motion in the elbow as a result of an earlier injury, such as a fracture.
- Contractures, a condition in which the muscles and tendons are abnormally contracted, limiting the range of motion; loose bodies, pieces of bone or cartilage that break loose and cause pain; catching and locking of the joint; and arthritis, a condition in which the cartilage, the tissue that allows bones to move smoothly against one another, wears away.
What Conditions Can Elbow Arthroscopy Treat?
A variety of diseases and injuries that affect the elbow joint can be treated with an elbow arthroscopy treatment. Compared to having your elbow replaced, it is far less intrusive.
The following conditions may be treated with elbow arthroscopy:
- Infection (septic arthritis).
- Inflammation (synovitis).
- Lose bone and cartilage (osteochondritis dissecans).
- Permanently tensed muscles (contractures).
- Rheumatoid arthritis.
- Scar tissue that limits mobility (adhesions).
- Dislocated elbow.
- Elbow fractures.
- Pitcher’s elbow (valgus extension overload syndrome).
- Tennis elbow (lateral epicondylitis).
Why Might I Need Elbow Arthroscopy?
Your doctor will typically advise non-surgical treatment, such as rest, anti-inflammatories, physiotherapy, and injections to reduce inflammation, before recommending any kind of surgery, for painful elbow issues. Surgery can subsequently be suggested if one of these treatments fails to improve your condition.
The majority of elbow issues are brought on by overuse, trauma, and aging-related wear and tear. The treatment for disorders like arthritis that harm the cartilage surface and other soft tissues surrounding the joint is elbow arthroscopy. It can also be used to relieve scar tissue that may be preventing movement or to remove loose bits of cartilage and bone.
Among the ailments that an elbow arthroscopy may help with is
- Tennis/golfers’ elbows.
- Osteoarthritis arthritis.
- Rheumatoid arthritis.
- Osteochondritis dissecans –a sports injury frequent in throwers and gymnasts.
Planning For Surgery:
Evaluations and Tests
To ensure that you have no medical issues that need to be resolved before surgery, your orthopaedic surgeon may request that you visit your primary care physician. Blood tests, electrocardiograms, and chest x-rays may be necessary to perform your surgery properly.
Before your surgery, a more thorough evaluation may be required if you have particular health risks. Make sure your orthopaedic surgeon is aware of any drugs or dietary supplements you are taking. Some of these may need to be stopped before surgery.
If you are generally healthy, an arthroscopy will most likely be performed as an outpatient procedure. You won’t have to spend the night at the hospital as a result.
Before your treatment, the hospital or surgery centre will get in touch with you to go over specifics. Follow the directions for when to come and, in particular, when to cease eating and drinking before your surgery.
A member of the anaesthesia team will discuss your options with you before the procedure. You are normally put to sleep during an elbow arthroscopy and given general anaesthetic.
Because the numbing effect can linger for several hours after the procedure is finished, regional nerve block injections that numb only the area around your elbow is rarely utilised in elbow arthroscopy. Even though the numbing effect can help with pain management, it prohibits your surgeon from performing a thorough nerve inspection in the recovery area to ensure that the nerves that go down your arm are in good condition.
After your surgeon has finished the nerve evaluation, a localised anaesthetic may be administered if it is required for pain management in the recovery area.
You’ll likely receive intravenous antibiotics and general anesthesia while you’re in the surgery room. To reduce the risk of infection following surgery, antibiotics are frequently administered before surgery.
The arthroscope will then be readily adjusted by your surgeon so they can see the inside of your elbow. For elbow arthroscopy, lateral decubitus (side laying) and prone are the two most popular postures (lying on your stomach). After alignment, special attention is paid to padding and protecting your spine as well as other pressure areas in your arms and legs.
The elbow is typically in this posture during surgery. An arm holder device holds the arm in place. Your upper arm is then wrapped in a tourniquet and set in an arm holder to maintain its position throughout the treatment. Your lower arm and hand can receive a compressive dressing to lessen swelling. Your skin will be sanitized with antiseptic by the surgical team, and sterile surgical drapes will be placed over your shoulder and upper body.
The ulnar nerve and olecranon bone, as well as the locations of incisions and ports for the arthroscope, are routinely marked on the elbow by the surgeon.
Portal placement technique-
- Before installing portals, thoroughly extend the joint across the lateral soft spot.
- When the trocar is inserted, the capsule distension causes the NV structures to migrate away from the joint.
- Using a hemostat with caution, “pick and spread” approach.
- Due to its proximity to the ulnar nerve, the posterior medial portal is usually avoided.
You will first be injected with fluid into your elbow joint by your surgeon. The fluid makes it easier for your surgeon to see the bones and muscles of your elbow using the arthroscope’s camera. This reduces the possibility of harm coming to the nerves and blood vessels that surround your elbow joints. To insert the arthroscope and small tools joint, your surgeon will make several tiny incisions.
The arthroscope is filled with fluid to reduce any bleeding and maintain a clean image. On the video screen, images from the arthroscope are shown, giving your surgeon a view of the inside of your elbow and any issues. Before starting any specific therapies, your surgeon will assess the joint. If necessary, the entire joint will be examined, which might call for five or seven extremely small arthroscopic incisions overall.
To help with the process, the surgeon will inject additional small devices through different incisions. For actions including shaving, cutting, gripping, suture passing, and knot tying, specialized equipment is utilized. Special tools are frequently used to secure stitches in bone.
What are The Risks of Elbow Arthroscopy?
Arthroscopy is a generally secure procedure. The elbow, however, is a little region of bone, muscle, blood arteries, and nerves. Compared to other, larger joints, such as the knee and shoulder, the elbow is treated with arthroscopy less frequently by surgeons.
Potential issues comprise
- sensitivity to anesthesia.
- Thrombosis, or blood clots (DVT).
- damage to the nerves or tissue nearby.
- extreme edema or bleeding
- discomfort or harm to the nerves.
As with any operation, there are potential dangers even though most people have no issues after elbow arthroscopy. Usually mild, curable, and unlikely to have an impact on your outcome. Infection, severe bleeding, blood clots, and injury to blood vessels or nerves are a few potential issues. The majority of research indicates that arthroscopy of the elbow joint carries a little higher risk of infection and nerve irritation/injury than arthroscopy of the shoulder and knee joints. Before surgery, go over the potential advantages and disadvantages with your orthopedic specialist.
Recovery from Elbow Arthroscopy Surgery
Because elbow arthroscopic surgery is performed as an outpatient treatment, patients can leave the hospital a few hours following the operation. The wounds left behind by the incisions made during arthroscopic surgery often heal within a few days. Patients’ recovery times will vary depending on the degree of their surgeries, but most people can resume their normal daily activities within a few days and can resume more intense activities and sports within a few weeks.