Other popular names
- Keyhole surgery
- Elbow scope
Why is it done?
If I think you have a problem inside your elbow joint then I may wish to look inside under direct vision with a camera. There are many reasons 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.
An arthroscopy it itself is a diagnostic procedure and whilst identifying problems, it not a treatment. An MRI scan can also show problems inside the elbow joint and is occasionally used as an alternative investigation.
This x-ray of an elbow taken from the side shows severe osteoarthritis. Note the large bone spurs that have formed around the joint. During an arthroscopic procedure, these bone spurs can be removed, along with any loose fragments of cartilage
Surgery is carried out as a day case procedure under regional or general anaesthetic. A simple look around takes about 15 minutes, but if other procedures need to be performed, it can take longer. Between 2 and 4 small 4mm 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 or secured using steristrips and a bulky dressing is applied.
You can go home soon after the operation. The anaesthetic will wear off after approximately 6 hours. Simple analgesia (pain killers) usually controls the pain and should be started before the anaesthetic has worn off. The dressing is removed a couple of days after the operation. The wound is cleaned and redressed with a simple dressing. The sutures/ steristrips are removed at about 12 days. Any further treatment that the arthroscopy has identified will be discussed at this visit.
Return to normal routine
Keep the wound dry until the stitches / steristrips are out at 12 days.
Return to driving:
The hand needs to have full control of the steering wheel and left hand the gear stick. You are advised to avoid driving for at least 7 days or until the sutures (stitches) are removed.
Return to work:
Everyone has different work environments. Returning to heavy manual labour should be delayed for approximately 4 - 6 weeks. You will be given advice on your own particular situation.
Overall over 95% are happy with the result. However complications can occur.
General risks (less than 1% each):
- Neuroma (nerve pain)
Reflex Sympathetic Dystrophy - RSD (<1% people suffer a reaction to surgery with painful stiff hands, which can occur with any elbow surgery from a minor procedure to a complex reconstruction).
- Injury to nerves of the forearm and hand as the arthroscopy is introduced (less than 1% of my patients)
- Injury to blood vessels