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The Elbow Joint
This joint where the upper arm bone and the lower arm bones meet is stabilized by ligaments. Three large nerves along with blood vessels pass through the arms and the elbow to supply blood circulation and nervous function to the hands and wrist distal to it.
The elbow is a very dynamic joint with a wide range of motion and it receives a lot of stress during sports and work where it is often used repetitively. It is also affected by changes of aging (arthritis) which may bring about limitation of motion and pain.
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What is Arthroscopy?
Arthroscopic surgeries are advanced technological methods done to diagnose and treat many conditions in the joints of the body. These involve the use of fiber optic instruments like telescopes with cameras to see the anatomy of joints through small portals (openings on the skin). The surgeon can view images on a monitor located in the operating room and at the same time perform arthroscopic surgery using instruments which can be inserted through the portals.
Elbow arthroscopy is one of such procedures, and while it is less commonly used compared to knee and shoulder arthroscopies, it remains to be a useful tool in diagnosing and treating elbow pain and disorders. It is usually done under general anesthesia, and the patient may be positioned lying on his back, on his side or prone, depending on the need for surgical exposure.
The indications for doing elbow arthroscopy are:
- Removing loose bodies (cartilage or bones) and bone spurs around the elbows
- Diagnosing causes of chronic elbow pain and limitation of movement, like stiff elbow release
- Evaluating and treating sports injuries to the joint and ligaments, like tennis elbow
- Evaluation and treatment of osteochondritis of the elbow
- Evaluation and treatment of rheumatoid arthritis (synovectomy of the elbow)
- Repair of torn ligaments and elbow fractures
- Removal of scar tissue
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Advantages of Arthroscopy
Elbow treatment by means of elbow arthroscopy minimizes surgical incisions while allowing good exposure of anatomy because it only needs small incisions to insert the scope and surgical instruments.
Because arthroscopy is less invasive, less bleeding and infections are expected, and therefore, recovery time is shorter than open elbow surgery. Patients usually experience less pain and recover greater range of motion faster than traditional surgical procedures. Furthermore, cosmetic appearance of the sites of incisions look better post-operatively.
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Risks and Disadvantages of Arthroscopic Surgery of the Elbow
Elbow arthroscopy is relatively difficult and needs great care and technical expertise on the part of the surgeon. This is because of the anatomy of the elbow, wherein bones and major nerves and blood vessels lie close to one another, making it vulnerable to inadvertent injury while inserting and manipulating instruments through small incisions.
The most common complication is nerve injury, while bleeding, infection and pain are less common.
Although elbow arthroscopy has a higher risk of complications than arthroscopy done in other joints, it is highly recommended for diagnosing and treating elbow injuries and degenerative changes.
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AANA, “Elbow Arthroscopy”, https://www.aana.org/VideoEducationLibrary/Articles/ElbowArthroscopy/tabid/126/Default.aspx
Techniques in Orthopaedics, "Basics of Elbow Arthroscopy: Setup, Portals, and Technique", http://www.plancherortho.com/education/research_pdfs/elbow/basics_of_elbow_arthroscopy.pdf