Your surgeon has suggested an elbow arthroscopy may help treat your problem. This leaflet will provide you with more information following your discussions with the surgeon in clinic.
There are a number of things that keyhole surgery to the elbow can help with:
- Painful – a number of conditions including tennis elbow
- Inflammed / swollen – Rheumatoid arthritis
- Stiff – Arthritis or following trauma
- Unstable / dislocating – Assessment of which ligaments might need reconstructing and sometimes arthroscopic repair or tightening
- Clicking, locking, popping, catching – Loose bodies often cartilage
- Fractures – some fractures that used to be fixed through open procedures can now be fixed through keyhole surgery
- Children & Young adults – some conditions affect the cartilage and can cause painful stiff elbows. Occasionally surgery can help.
You will normally be admitted as a day case procedure under general anaesthetic (asleep for the surgery), so should not eat or drink anything from midnight on the day of surgery. Sometimes, you may be required to stay in hospital for a day or two especially if postoperative physiotherapy is required.
You will be positioned on your side and a tourniquet will be placed around your upper arm to prevent bleeding during the operation. Around 5 small cuts will be made on the side and back of the elbow through which we will insert the camera and instruments to do the surgery required. We pump fluid into the elbow during the operation, which always causes a small amount of swelling. The wounds are closed and these stitches must be removed. We will try to take photos to show you in clinic but this is not always possible.
Depending on the procedure, a plaster may be applied or more likely a bulky bandage. You must perform regular hand and wrist exercises and gently start to move the elbow as tolerated unless instructed otherwise. The bandage can be removed around 3-5 days following surgery, but the wounds should be left covered until the stitches are removed around 2 weeks following surgery.
Complications are rare. The general complications included bleeding, infection, pain and stiffness in the elbow. The serious risk is that of nerve injury which could lead to permanent hand or wrist disability (around 1:500 risk). We try and minimise this risk by using fluid to push the nerves away from where we are working and making our incisions/cuts in safe areas of the elbow.
Arthroscopic elbow surgery is very demanding, so sometimes we may be unable to complete the surgery because of technical difficulty or swelling (risks nerve injury). In these cases we will either convert to an open procedure on the day or decide to stop the operation and return another day when the swelling has subsided to complete the job via open surgery.
In most cases there is a 90% chance of improvement in your symptoms by around 3 months following surgery. In some cases we will be using arthroscopy to diagnose you where scans have not been able to. Very rarely you will feel that your elbow is worse following surgery than before and this is normally secondary to a complication.