- Procedure Details
- Risks / Benefits
- Recovery & Outlook
Arthroscopy is often performed by orthopedic surgeons to examine joint problems and provide treatment. The elbow is a joint such a procedure is used for. Arthroscopic instruments may be used to address inflammation of soft tissues and damage to bone, cartilage, or nerves. This minimally invasive surgical option became possible through fiber optic technologies and equipment, beginning in the 1960s, and is now common worldwide, often enabling patients to go home the day of the procedure.
What Is Arthroscopy?
In Greek, “arthro” means joint, while “skopein” means to look. The literal translation is “to look within the joint,” and that is what occurs during an arthroscopic procedure. Arthroscopy can be used for diagnosis and treatment purposes.
Creating small incisions, the surgeon can insert pencil-sized instruments—sometimes just a few millimeters in diameter—that provide imaging and light. Structures inside a joint such as the elbow can be illuminated and magnified. A miniature television camera at the end of the instrument is connected through fiber optics to a system that enables surgeons to view the interior structures on a television screen.
How It Is Done
During arthroscopic surgery, anesthetics are used, which can be local. Sometimes patients receive a spinal or general anesthetic, depending on the procedure and problem being treated. The primary incision is usually not larger than a buttonhole. However, other incisions may be made to better visualize the joint or insert instruments to perform the surgery.
Compared to open types of elbow surgery, recovery time is shorter. There is also generally less trauma and pain involved with the procedure because the incisions are smaller than with traditional operations. However, the extent of the surgery and recovery time depend on the problem being treated. Some issues are more complex, or the images obtained may reveal additional injury or disease. In such cases, open surgery may be performed, or the surgeon will discuss the options with you after the anesthesia wears off.
For patients with inflammatory arthritis, the localized inflamed joint tissue may be removed. Joint tissues are sometimes biopsied to determine the cause of the problem. Other conditions or infections may be revealed in this manner, especially if drawing fluid out of the joint and analyzing it doesn’t provide conclusive evidence.
During arthroscopy, instruments can be maneuvered once placed in the incision. These include cutting instruments and tools that can remove and suture tissues. When surgeons complete the procedure, they remove the arthroscope and other instruments, close the incisions with sutures, and place a sterile dressing over the area. The joint may then be braced or wrapped.
Reasons for Elbow Surgery Using Arthroscopy
The need for surgery is determined by the results of physical exams, x-rays, and magnetic resonance imaging and computed tomography scans. A doctor will look at your medical history as well. Elbow arthroscopy is often used to treat:
- Disease of bones, ligaments, cartilage, tendons, and muscles.
- Inflammation of soft tissues that can affect nerves and mobility.
- Injury to cartilage or bone that may leave loose fragments inside.
- Compressed or entrapped nerves, such as the ulnar nerve.
- Torn ligaments that have been damaged due to disease or injury.
The elbow is one of six joints most frequently examined and treated with arthroscopy; the others are the knee, shoulder, hip, wrist, and ankle.
Preparing for Surgery
Arthroscopic elbow surgical procedures generally don’t require that much preparation on the patient’s part, but your overall health will be examined thoroughly beforehand. Your heart, liver, lungs, and kidneys will be tested to be sure you can tolerate the anesthetic. Doctors will ensure any underlying conditions, such as emphysema, heart disease, high blood pressure, or diabetes, are managed and that medications such as blood thinners are properly adjusted.
Blood and urine tests will be performed. Your doctor will check for infections, which can delay surgery. The exception is if the infection involves the troublesome joint. Other pre-operative tests may include a chest x-ray and an electrocardiogram, especially if you’re over 50.
Although rare, complications can include infection, bleeding, and swelling. Blood clots are a possibility, as is damage to tissues, blood vessels, and nerves. There is a small risk that surgical instruments can break during the operation. Seek medical help immediately if you have fever, worsening pain, numbness or tingling in the area, severe swelling, or there is a discolored, odorous fluid seeping from the incisions.
Elbow Arthroscopy Recovery Time
While puncture wounds made to insert the instrument heal within a few days, the joint may take several weeks. Your activity may be limited, and rehabilitation may be needed to maximize recovery. As for the wound, operative dressings are often removed the next morning and all you’ll need thereafter are adhesive strips to cover the incisions.
Patients often return to work or school within a few days. If you’re athletic and/or in good physical shape, normal activities can resume within a few weeks, but the actual diagnosis and presence of other conditions can affect recovery, which varies from person to person. The exact time for elbow arthroscopic recovery is, therefore, unique to each individual patient.