Elbow arthroscopy is a key-hole operation for elbow problems. Key-hole surgeries of knee are very common and familiar to most people. Other joint problems such as shoulder, elbow, wrist, ankle and some of the even smaller joints can be treated by key-hole surgery. Purpose of doing an operation by key-hole method is to minimise tissue damage and thereby getting quicker recovery. These operations are usually done as day cases and recovery is much quicker compared to open operations.
Conditions of elbow where arthroscopic surgery is commonly performed with good effect are those which are connected with Arthritis including Rheumatoid arthritis (RA). In arthritis sometimes there are loose pieces of bone (loose bodies) in the joint causing pain and sensation of locking. These can be removed arthroscopically. In RA the lining of the joint is inflamed and swollen and this lining can be removed (synovectomy) by key-hole surgery. There are other conditions which can affect younger individuals resulting in loose bodies, which are also treated by this method. Elbow stiffness which results from previous injury and fractures are also sometimes amenable to this operation but the results are unpredictable and open operations are preferred. Some surgeons have tried to treat tennis elbow by this method but its usefulness is not yet known. Elbow arthroscopy is sometimes performed to diagnose a problem or to assess the degree of arthritis in the joint (Diagnostic arthroscopy).
When you see your surgeon with an elbow condition, you will first be examined and usually an x-ray will be done. If elbow arthroscopy is considered necessary, then you will require either a CT or MRI scan to look at the problem with greater clarity and detail. The risks and benefits of the operation will be discussed. Risks are few and not common. One of the risks is damage to an adjacent nerve. This damage is uncommon and mostly partial and therefore recovers in majority after a few months. In rare circumstances when the nerve damage is complete, permanent loss of feeling in part of hand and some loss of movements may happen. The risk of this type of complication is less than 1%. Other risk includes infection, swelling and bleeding especially after synovectomy (see above). The operation is done under General Anaesthetic and most patients go home on the day of operation unless there are other medical reasons to keep you in hospital longer.
Initial bandage is removed after 2-3 days and some movements are encouraged. It is often necessary to have some physiotherapy to help recover movements and strength.
FRCS (Trauma & Orth)
Consultant Trauma and Hand Surgeon