Elbow
Arthroscopy
INTRODUCTION
The elbow
joint is a
hinged joint
where the
upper arm
bone (humerus)
meets the
two forearm
bones (ulna
and radius).
The main
stabilizing
structure of
the elbow
joint is the
ligament
along the
inner aspect
of the elbow
(medial
collateral
ligament.)
The unique
anatomy of
the elbow
joint allows
it to pass
through a
broad range
of motion.
During
repetitive
overhead and
lifting
sports and
occupations,
the elbow
experiences
tremendous
stress. This
may lead to
the
formation of
small loose
fragments of
cartilage or
bone (loose
bodies) or
elbow joint
spurs.
Arthroscopic
surgery of
the elbow is
challenging
because of
the joint's
anatomy. The
bones lie
close
together,
and nerves
and blood
vessels are
located very
close to the
joint (see
illustration).
Therefore,
the doctor
must be
especially
careful when
inserting
the
arthroscopic
instruments
into the
joint.
Although it
is a
difficult
procedure,
arthroscopic
surgery is
often the
ideal choice
for treating
certain
elbow
conditions.
An injury or
arthritis
can damage
the ends of
the bones
and cause
bone spurs
to develop.
These spurs
can be
painful and
make it hard
to move the
elbow. The
doctor can
remove the
spurs by
using
special
tools, such
as a burr,
inserted
into the
joint
through the
portals or
small
incisions.
After the
spurs are
removed, the
elbow moves
more easily
and with
less pain.
Arthroscopy
is a
surgical
procedure
where
optical
instruments
are used to
visualise
the inside
of a joint.
This can be
done through
very small
skin
incisions
and then
allow
treatment of
problems
within the
joint to be
performed
through
other very
small skin
incisions.
Arthroscopy
has
dramatically
altered the
approach to
the
diagnosis
and
treatment of
a variety of
joint
ailments.
Arthroscopy
can be used
to aid in
diagnosis,
to determine
prognosis
and most
importantly,
to provide
treatment.
Arthroscopy
of most of
the larger
joints is an
extremely
safe
procedure
and has very
few
complications.
In recent
years, the
role of
elbow
arthroscopy
has expanded
dramatically
and is
becoming a
much more
common
procedure.
Elbow
arthroscopy
has the
potential to
be hazardous
to important
nearby
nerves and
vessels,
more so than
with most
other
joints.
Placing the
viewing
telescope
and
instrument
in the
correct
place and
being very
careful with
surgical
technique,
significantly
diminishes
the risk to
the
structures.
There are
few
contraindications
to elbow
arthroscopy.
There are
many
situations,
however,
that might
make the
procedure
more
difficult or
may preclude
the use of
certain
portals for
access to
the joint.
This
includes
situations
such as
ulnar nerve
transposition
or prior
surgery that
alters
normal elbow
anatomy.
The surgery
will be
performed
under a
general
anaesthetic.
Once you are
asleep, you
will be
placed on
your side
and the arm
to be
operated on
will be
placed over
an arm
holder.
Multiple
skin stabs
will then be
made to
allow access
of both the
viewing
camera and
the
operating
instruments
into your
elbow joint.
The joint
will be
thoroughly
inspected
and then any
pathology
will be
treated at
the time.
Elbow
arthroscopy
is
particularly
helpful
for...
 Removal
of loose
bodies.
Evaluation
and
treatment of
OCD.
Evaluation
and
treatment of
damaged
joint lining
surfaces.
Removal
of bone
spurs.
Synovectomy
- especially
for
rheumatoid
arthritis.
Stiff
elbow
release.
Tennis
elbow
release.
Evaluation
of
instability.
THE
OPERATION
An elbow
arthroscopy
introduces
an
arthroscope
(small
'telescope')
into the
elbow joint
through
several
small 2-3
millimeter
incisions.
The
arthroscope
is used to
identify the
location of
the loose
bodies and
the spurs.
The loose
bodies can
be removed
by using the
arthroscope
in addition
to small
grasping
instruments.
The bone
spurs can be
removed by
visualizing
the spur
with the
arthroscope
and using a
small burr
to remove
the spur.
These elbow
arthroscopic
procedures
take about
30-90
minutes and
are done on
an day-case
basis
(without an
overnight
stay in the
hospital).
Elbow Arthroscopy with Loose Body
Removal of
Loose Body
 |
Elbow
Arthroscopy