Reasons to Perform Arthroscopic Elbow SurgeryNot all causes of elbow pain can be effectively treated with an arthroscopic procedure. Some of the reasons to perform an arthroscopic elbow surgery, or elbow arthroscopy, include:
- Removing Loose Debris
The elbow joint can collect loose debris or cartilage as a result of arthritis or injury. These loose bodies within the joint can cause pain and limited motion. Arthroscopic surgery is a minimally invasive way to remove this problem debris.
Removing Bone Spurs
In early stages of elbow arthritis, bone spurs may form around the joint, and impede normal motion of the joint. An arthroscopic procedure may be appropriate to remove the bone spurs to restore more normal motion of the elbow joint.
A specific elbow problem, called "thrower's elbow," occurs in throwing athletes such as baseball pitchers. Because of the tremendous forces on the elbow, a bone spur can form in the back of the joint. If nonsurgical treatments fail to relieve symptoms, an arthroscopic surgery may be helpful to remove this spur.
- Loosening the Joint Capsule
The elbow joint is notorious for stiffening as a result of injury, surgery, or other trauma to the joint; this condition is called elbow arthrofibrosis. In some patients, the elbow joint capsule may become so tight that motion is limited. Surgically loosening the joint capsule may be possible in these patients. The advantage of an arthroscopic approach is that less scar tissue is likely to form after surgery, thus making the chance of regaining motion more likely.
- Assessing Cartilage Damage
Specific cartilage problems, most commonly osteochondritis dissecans (OCD), can cause problems in the elbow joint. X-rays and MRIs may not adequately show the extent of the damage, and an arthroscopic surgery can be used to assess the extent of cartilage damage to determine if further treatment is needed.
- Tennis Elbow
Tennis elbow occurs when there is microscopic tearing of the tendons on the outside of the elbow joint. While most people improve with non-surgical treatments for tennis elbow, sometimes surgery is necessary. Traditional surgery detaches the tendon from the bone, removes the damaged tendon, followed by a repair or reattachement of the tendon.
Arthroscopic surgery has become a treatment option for tennis elbow. Arthroscopic procedures allow your surgeon to look within the elbow joint to ensure there is no other source for the pain, and also allows for removal of damaged tendon without detachment of the tendon from the bone. While arthroscopic surgery for tennis elbow is relatively new, early results have been encouraging with high rates of success.
Performing Arthroscopic Elbow SurgeryElbow arthroscopy can be done under general or regional anesthesia. After adequate anesthesia, your surgeon will create 'portals' to gain access to the elbow joint. The portals are placed in specific locations to minimize the potential for injury to surrounding nerves, blood vessels, and tendons. Through one portal, a camera is placed into the joint, and through others, small instruments can be used to address the problem.
The length of the elbow arthroscopy procedure varies depending on what your doctor needs to accomplish. After surgery, your elbow will get put in a soft bandage or splint. Most patients will work with a physical therapist to regain motion and strength of the joint. The length of rehabilitation will also vary depending on what is performed at the time of surgery.
ComplicationsThe most concerning complication of arthroscopic elbow surgery is injury to one of the major nerves that surround the elbow joint. Several nerves that are critically important to hand function are around the joint. Other complications include infection and damage to joint cartilage from the arthroscopy instruments.
Dodson CC, et al. "Elbow Arthroscopy" J. Am. Acad. Ortho. Surg., October 2008; 16: 574 - 585.