Elbow arthroscopy

Elbow

Elbow arthroscopy is a minimally invasive technique used by orthopedic surgeons to diagnose and treat a variety of conditions that affect the joint.

Like other joints, elbow arthroscopy involves the use of fiber optics and a tiny camera inserted through small incisions, or portals. The magnified images from the camera are projected onto a television monitor in the operating room. When the procedure is used to treat an injured or diseased joint, the orthopedic surgeon inserts miniaturized surgical instruments through an additional portal.

Unlike traditional surgery, which uses large incisions to open the joint, the surrounding soft tissue is not injured with arthroscopy. Additionally, the technique allows the surgeon to view the elbow joint from multiple angles, allowing for a more comprehensive evaluation.

Before performing an elbow arthroscopy, the orthopedic surgeon obtains magnetic resonance imaging (MRI) and x-rays of the joint. Respectively, these images provide information about the soft tissues surrounding the bones (cartilage, tendons, and ligaments) and the bones themselves that may have irregularities, including spurs (additional growths that can cause pain and inflammation). Portal placement can also be guided by these findings.

Elbow arthroscopy is used as a diagnostic tool for pain, stiffness, and loss of motion in the joint. Some of the more common diagnoses include:

• Adhesions, bands of soft tissue that block movement as a result of a previous injury to the elbow, such as a fracture.
• Contractures, a condition in which muscle and tendons contract abnormally, limiting range of motion, loose bodies , fragments of bone or cartilage that break off and cause pain, entrapment, and locking of the joint.
• Arthritis, a disease characterized by the wearing away of cartilage, the tissue that helps bones glide smoothly against each other during movement.

Arthritic bone can be debrided, a technique that makes contacting surfaces smoother and less likely to cause stiffness and entrapment during movement. Loose bodies can be removed and adhesions and contractures can be eliminated, thus improving or restoring range of motion. And, some orthopedic surgeons use arthroscopy to debride or cut the diseased portion of the tendon in tennis elbow.

Although elbow arthroscopy was developed more than a decade ago, it is still less widely used than arthroscopy of other joints, such as the knee or shoulder. The limitations of working on the elbow, a very narrow space in which the nerves pass very close to the joint, require specialized training. The proximity of those nerves also constitutes the greatest risk specific to the procedure, nerve injury that can result in temporary numbness.