Arthroscopic Elbow Surgery
The development of the arthroscope has really changed the nature of most orthopedic surgery. This is especially true of the elbow. Smaller incisions. Less trauma and joint stiffness. Shorter recovery times. These are all the result of arthroscopic methods.
Arthroscopic elbow surgery has been performed since the 1980s, but techniques continue to evolve, making this surgery much easier and recovery much faster. At the Center for Advanced Orthopedics and Sports Medicine, Drs. Elias and Mashoof perform arthroscopic elbow surgery for patients from all around the L.A. area.
What is arthroscopic elbow surgery?
Arthroscopic techniques are used in lieu of open surgery to visualize, diagnose, and address problems inside the elbow joint. The elbow is made up of three bones: the upper arm (humerus), the forearm on the pinky finger side (ulna), and the forearm on the thumb side (radius). Its main movement is to allow bending and straightening, but forearm rotation also places certain unique pressures on the joint. Problems with the elbow are usually the result of injury, overuse, and simple age-related wear and tear.
Although conservative treatments are always the first course of treatment (except in traumatic injuries), when they fail to improve the patient’s ongoing pain surgery may be necessary.
At the Center for Advanced Orthopedics and Sports Medicine, common arthroscopic procedures we perform on the elbow are:
- Treatment of osteoarthritic joint damage
- Treatment of rheumatoid arthritis joint damage
- Treatment of tennis elbow
- Removal of loose bodies (cartilage and bone fragments)
- Release of scar tissue to increase range of motion
- Treatment of osteochondritis dissecans (activity damage to the capitellum portion of the humerus)
How is arthroscopic elbow surgery performed?
If the patient is in good health, these are typically outpatient procedures we perform at Cerritos Surgery Center. The patient usually receives general anesthesia.
Dr. Elias or Dr. Mashoof make several small incisions to provide access for the arthroscope and other small surgical instruments. The joint is filled with saline solution to open space and allow a clearer view inside the joint with the arthroscope. This serves to also lessen the possibility of damaging surrounding nerves and blood vessels.
Once we have good visuals of the inside of your elbow joint, we can evaluate your problem, damage, etc. Then we plan how to repair the damage.
Depending upon your situation, we insert specialized instruments for tasks such as shaving, cutting, grasping, suture passing and knot tying, and a device for anchoring stitches into bone. When the repair is complete, we apply skin tape and absorbent dressing. In some cases, we may then apply a plaster splint to restrict movement and provide better protection. In others, an additional soft dressing is applied that protects but also allows movement.
Who is a good candidate for arthroscopic elbow surgery?
Elbow arthroscopy may be the next step if your chronic pain in the joint is not responding to conservative treatments such as rest, physical therapy, and medications or injection of corticosteroids to calm inflammation. In the elbow, inflammation causes swelling, pain, and stiffness.
Elbow arthroscopy may be used to relieve painful symptoms of many problems that damage the cartilage surfaces and other soft tissues surrounding the joint. It also may be necessary to remove loose pieces of bone and cartilage from prior injury. If scar tissue has formed and is impeding the patient’s movement in the joint, arthroscopy is an effective option for releasing the scar tissue.
Are there cases where arthroscopic methods may not be the best approach?
In some cases, open surgical methods may still be the best option. These would include surgeries to:
- Treat golfer’s elbow
- Repair collateral ligaments
- Fix many fractures
- Replace the elbow joint
- Decompress the ulnar nerve
What is recovery like after arthroscopic elbow surgery?
Although arthroscopic methods typically allow for a faster recovery, it will still likely be a few weeks before you are fully recovered. Your timeframe obviously varies dramatically depending upon the reason for the surgery. For instance, cleaning out bone fragments will be a much faster recovery than reattaching a torn muscle.
There will be some pain and discomfort for at least your first week with more simple procedures. Your first few days will likely require prescription pain medication. Elevating your elbow and icing it is very important for the first two days after your surgery. The goal is to have your elbow higher than your heart when lying flat and to have your hand higher than your elbow.
You’ll be encouraged to move your fingers and your wrist to stimulate circulation and minimize swelling. We may give you some early range-of-motion exercises to prevent stiffness. We’ll start you on gentle exercises as soon as appropriate. Your return to normal activities will vary depending on the extent of your surgery.
Rehabilitation with exercises to regain elbow and forearm motion and strength will be a part of your recovery. These may simply be performed on your own, or in more involved surgeries they will involve a physical therapist.
Is elbow surgery recovery painful?
These aren’t overly painful thanks to the small incisions used with arthroscopy. But for at least the first week there will be some pain. You’ll need pain medication for probably a couple days at least.
What are the risks involved with arthroscopic elbow surgery?
Despite being less invasive, these are still major surgeries, so they involve the risks inherent in any surgery: reaction to anesthesia, excessive bleeding, development of blood clots, infection, and damage to blood vessels or nerves. Studies show there is a slightly higher risk of infection with elbow arthroscopy than with shoulder or knee arthroscopy. The risks are still low, however. These surgeries with Dr. Elias and Dr. Mashoof are successful and effective.
Does insurance cover arthroscopic elbow surgery?
Yes. Health insurance plans cover these procedures. They must follow a period of application of conservative treatments, but when those are unsuccessful for solving the patient’s elbow pain or lack of functionality, surgery is then deemed medically necessary and covered by insurance.
Schedule Your Appointment Today!
For more information on arthroscopic elbow surgery or to schedule an appointment with Center for Advanced Orthopedics & Sports Medicine contact us today. Our practice serves Cerritos, Fountain Valley and the surrounding areas of California.