As for other large joints, keyhole surgery techniques are now capable of addressing many conditions. Elbow arthroscopy is able to provide your surgeon with an excellent view of the structures inside your elbow and keyhole techniques can be employed to address: loose body removal; tennis elbow release; elbow Arthrolysis; elbow Impingement surgery (Osteoplasty) and radial head resection.
The procedure is performed under general anaesthetic. Local anaesthetic is infiltrated into your joint. The Arthroscope and instruments are then carefully inserted into your elbow joint through tiny incisions. Your joint surfaces are inspected and any problems identified and managed accordingly.
View of antero-lateral aspect of elbow, with arthroscope passed through antero-medial portal. Needle passed into joint through lateral side
This is a view of the posterior elbow compartment. A loose body (highlighted with dashed line) is floating in this compartment. This was removed to treat clicking, pain and locking of the elbow.
This is generally a safe procedure, but there are some specific risks relating to arthroscopy of the elbow:
Nerve injury is slightly more common after keyhole surgery to the elbow, although this is normally a temporary problem. The nerves that cross your elbow pass close to the entry points for the Arthroscope and surgical instruments. The way Mr Granville-Chapman accesses and operates within your elbow is designed to minimise the risk of nerve injury. However, injury to nerves may still occur.
The ulna nerve passes just behind the inside knuckle (medial epicondyle) of your elbow. Permanent injury is very rare, but temporary altered sensation in your little and ring finger can occasionally occur. If the nerve is injured more severely it could also produce weakness of grip in your hand.
The posterior interosseous nerve is a motor nerve that supplies many of your forearm and finger muscles. It runs within a muscle very close to your elbow and is potentially vulnerable. Again, permanent injury is very rare, but if it were to happen, this could cause significant weakness in your wrist and hand that might require reconstructive surgery.
Infection is rare after keyhole surgery (<1%)
Wound healing problems are uncommon and Mr Granville-Chapman will suture your portal sites to minimize this risk.
This is normally a day case procedure. You may take down your bulky bandages after 3 days, but please keep your wounds dressed for 14 days. You can shower after 4 days with your dressings on. Please begin your painkillers as soon as you get home and continue them regularly for the first few days. Unless told otherwise, you can begin gentle elbow motion the day after your surgery and discard the sling when comfortable.
You will be seen two weeks after surgery and thereafter according to your needs.
Return to work and normality will vary depending on what’s been done in your elbow and your own pace of recovery. As a minimum, you should plan 2 weeks off work and driving, but you may require longer.