Elbow Arthroscopy

Mr Mike Hayton
FRCS(Trauma and Orth) FFSEM (UK)
Consultant Orthopaedic Hand Surgeon

Other common names

 - Keyhole surgery
 - Elbow scope

Why is it done?

If your surgeon thinks you have a problem inside your elbow joint they may wish to look inside under direct vision with a camera. There are many reasons for us to wish to do this and include diagnosing loose bodies, arthritis and cartilage damage/tears. There are an increasing number of treatments used with the arthroscope including trimming or repairing torn cartilage, removing loose bodies, removing inflamed lining of the joint and removing arthritic bone overgrowth.

Investigations

An MRI scan can also show problems inside the elbow joint and is occasionally used as an alternative investigation

Operative treatment

The surgery is a day case procedure under general anaesthetic. A simple look around takes about 15 minutes, but if other procedures need to be performed, it can take longer. Approximately 3 or 4 small 3mm incisions are made around the elbow to allow the camera and instruments inside. Care is taken not to injure the nerves just under the skin. After the arthroscopy the skin is sutured and a bulky dressing is applied.

Post-operative rehabilitation

The patient is fit to go home soon after the operation. The anaesthetic will wear off after approximately 6 hours. Simple analgesia usually controls the pain and should be started before the anaesthetic has worn off. My preference is to remove the dressing at 2 days. The wound is cleaned and redressed with a simple dressing. The sutures are removed at about 10 days. Any further treatment that the arthroscopy has identified will be discussed at this visit.

Return to activities of daily living

It is my advice to keep the wound dry until the stitches are out at 10 days.

Return to driving:

The hand needs to have full control of the steering wheel and left hand the gear stick. It is probable advisable to delay returning to driving for at least 7 days or even once the sutures are removed.

Return to work:

Everyone has different work environments.
Please ask your surgeon for advice on this.

Complications

Overall greater than 95% are happy with the result. However complications can occur.
There are complications specific to elbow arthroscopy and also general complications associated with upper limb surgery.

General complications:

 - Infection (Less than 1%)
 - Neuroma (Less than 1%, a coiled painful nerve bundle) 
 - Numbness

Reflex Sympathetic Dystrophy - RSD (2% bad reaction to surgery with painful stiff hands- this can occur with any hand surgery from a minor procedure to a complex reconstruction.)

Specific complications:

Injury to nerves of the forearm and hand as the arthroscopy is introduced (less than 5%).