Elbow Arthroscopy

 Elbow Arthroscopy

What is elbow arthroscopy?

Elbow arthroscopy is a minimally invasive surgical technique used to evaluate and treat a variety of conditions affecting the elbow. This technique involves several (2-6) small (1-2 cm) incisions. Fluid is pumped into the elbow to distend space within the elbow joint.

A small camera (known as an arthroscope) is inserted into the elbow via one of the incisions. Small instruments, such as a probe, scissors, or shavers, are inserted into the other incision(s) to perform the  surgery.

What conditions can be treated by an elbow arthroscopy?

Elbow arthroscopy is commonly used to remove loose bodies. It can also be used to treat lesions involving the articular cartilage, such as osteochondritis dissecans (or OCD) lesions.

Elbow arthroscopy is frequently used to break up scar tissue or adhesions which cause pain and limited elbow range of motion. In addition elbow arthroscopy can also be used for diagnostic purposes in patients who fail to respond to non-surgical treatments.

What can you expect when undergoing elbow arthroscopy?

Although elbow arthroscopy is a minimally-invasive, outpatient procedure, it is still a surgical procedure which requires general anesthesia. As a result your Phoenix orthopedic doctor will typically require that pre-operative blood work be obtained prior to undergoing surgery. In addition for patients over the age of 40 or with history of medical problems, often medical clearance obtained from your primary care physician will be required. Once blood work and/or medical clearance has been obtained then the surgery is scheduled.

Prior to surgery patients taking any anti-inflammatory medications (such as Advil, ibuprofen, or Naprosyn) should discontinue these for 1 week prior to surgery to decrease the risk of bleeding intra-operatively. In addition blood thinners (such as aspirin, Plavix, or Coumadin) will also need to be discontinued for 5-7 days prior to surgery to decrease the risk of bleeding.

You should have nothing to eat or drink after midnight the night prior to your surgery. Typically you will be instructed to arrive at the surgery center 90 minutes prior to the surgical procedure. You will check in at the surgery center and an IV will be placed.

Elbow arthroscopy is typically performed under general anesthesia. Typically local anesthetics are used as a supplement at the completion of the procedure. It is important to be aware that these will provide short-term pain relief after the surgery but will wear off within 6-12 hours post-operatively.

Surgery typically takes 60-90 minutes to complete depending upon the amount of damage within the elbow and the nature of the procedure that is being performed. During the elbow arthroscopy, the surgeon will take pictures of the structures within the elbow, including the chondral surfaces and bones. Your surgeon will review these photographs with you during your first post-operative follow-up appointment, which should occur approximately 7-10 days following the surgery.

Nearly all arthroscopic elbow surgery is done on an outpatient basis. Most patients recover in the recovery room for 45-60 minutes before being allowed to go home. Be sure to have someone with you to drive you home.

The post-operative instructions will depend upon the nature of the procedure performed. For detailed instructions regarding routine elbow arthroscopy see the post-op elbow arthroscopy instructions.

What are the potential complications associated with the arthroscopy?

As with any surgery, there are risks associated with elbow arthroscopy. The most serious potential complication is damage to one of the blood vessels or nerve structures that surround the elbow joint. Other potential problems associated with elbow arthroscopy include infection (< 1%), inadvertent damage to the cartilage surfaces of the elbow during the procedure, failure to eradicate symptoms, and medical complications associated with anesthesia.

Warning signs that suggest a potential complication is occurring include the presence of fevers greater than 101.5°, persistent warmth or redness around the elbow, increasing or uncontrollable pain, or significant swelling in the elbow.