Elbow arthroscopy, also referred to as keyhole or minimally invasive surgery, is performed through tiny incisions to evaluate and treat elbow joint conditions.
The Elbow is a complex hinge joint formed by the articulation of three bones - humerus, radius and ulna.
The three joints of the elbow are
- Ulnohumeral joint, the junction between the ulna and humerus
- Radiohumeral joint, the junction between the radius and humerus
- Proximal radioulnar joint, the junction between the radius and ulna
The elbow moves on the joint cartilage and is held in place with the support of various soft tissues including:
- Tendons, ligaments and muscles
Indications of elbow arthroscopy:
Elbow arthroscopy is usually recommended for the following reasons:
- Debridement of loose bodies such as bone chips or torn cartilage tissue
- Removal of scar tissue
- Removal of bone spurs: These are extra bony growths caused by injury or arthritis that cause pain and limited mobility.
Arthroscopy is also used for the:
- Treatment of osteoarthritis, rheumatoid arthritis, and a condition called osteochondritis dissecans where loose fragments of cartilage and bone are in the joint space. This is more common in throwers.
Evaluation and Diagnosis:
Professor Bain will review your medical history and perform a complete physical examination. Diagnostic studies may also be ordered such as X-rays, MRI or CT scan to assist in diagnosis.
Arthroscopy is a surgical procedure in which an arthroscope, a small soft tube with a light and video camera at the end, is inserted into a joint to evaluate and treat a variety of conditions.
Elbow arthroscopy is commonly performed under general anaesthesia as a day surgery procedure. The patient is placed in a lateral position which allows the surgeon to easily adjust the arthroscope and have a clear view of the inside of the elbow.
Several tiny incisions are made to insert the arthroscope and small surgical instruments into the joint. To enhance the clarity of the elbow structures through the arthroscope, Professor Bain will fill the elbow joint with a sterile liquid.
The liquid flows through the arthroscope to maintain clarity and to restrict any bleeding. The camera attached to the arthroscope displays the internal structures of the elbow on the monitor and helps to evaluate the joint and direct the surgical instruments to fix the problem.
At the end of the procedure, the surgical incisions are closed by sutures, and a soft sterile dressing is applied.
The advantages of arthroscopy compared to traditional open elbow surgery include:
- Smaller incisions
- Minimal soft tissue trauma
- Less post-operative pain
- Faster healing time
- Lower infection rate
The post-surgical instructions include:
- Raise your elbow on pillows above the level of the heart to help reduce swelling.
- Keep the wounds clean and dry.
- Pain medications will be prescribed to keep you comfortable.
- Physiotherapy may be ordered to increase elbow motion and strength.
- Eating a healthy diet and not smoking will promote healing.
The possible complications following elbow arthroscopy include infection, stiffness, swelling, bleeding, and damage to nerves or blood vessels.