How is the procedure performed?
The procedure is performed under a combination of general and regional anaesthesia. An arthroscope is inserted into the joint after distending it with saline. The inside of the joint is examined. Any associated problems in the joint are treated at this stage. Loose bodies are removed with a special grasping tool.
Benefits
The main benefit of the procedure is to relieve symptoms of catching and locking, which in turn allows an improvement in the function of the elbow. More than 90% of patients achieve benefit from surgery.
Risks
Pain - The elbow may be painful for some days after surgery. This is usually managed by taking appropriate pain relieving medication and activity modification.
Swelling – During the procedure, the joint is distended with saline and this may lead to the elbow remaining swollen for a day or two after surgery. You should keep your elbow elevated as far as possible to help relieve the swelling.
Bleeding – A small amount of bleeding from the arthroscopy portal sites is not unusual and will usually settle after a day or two.
Stiffness – This may occasionally occur after any form of elbow surgery. Prevention is the key and it is essential to perform daily stretching and exercises at home to keep the joint moving.
Infection – Infection is a possibility but rare after arthroscopic surgery (1%).
Persistent drainage – Persistent drainage is rare but may suggest infection and you should seek attention immediately.
Nerve injury – Injury to the nerves around the elbow is possible but rare. This may result in temporary numbness or weakness around the hand, wrist or forearm (3-5%). Permanent nerve injuries are extremely rare (<1%).
Aftercare
Following the procedure the arthroscopy portal sites (skin incisions) will be closed with tape or sutures and covered with shower-proof dressings. These dressings should be left undisturbed as far as possible for 5-7 days. If the dressings are removed for any reason they should be replaced with similar dressings or waterproof plasters. A compression bandage is applied after surgery and will usually be removed the next day. A sling will be provided to support the arm, but may be removed as tolerated to move the arm and is usually discarded after 2-3 days. A physiotherapist will provide instructions about mobilising the elbow prior to discharge from hospital. Outpatient physiotherapy may occasionally be recommended but is not always necessary. You may resume driving after 5-7 days. Sutures are removed after 12-14 days.
Follow-up
An appointment will be arranged for you to be seen in the outpatient clinic within two to four weeks after the procedure. Follow-up is required for at least 3-6 months after surgery or until a satisfactory recovery is achieved.