Certain elbow conditions may require surgery, especially if conservative treatment options haven’t been successful. For example, elbow tendon tears may require surgery to remove or repair damaged tissue and restore strength.
Some elbow surgeries can be done with an arthroscope. During this surgery, your surgeon places their surgical instruments through two small incisions to make repairs. An arthroscope causes less harm to healthy tissues and greatly reduces recovery time compared to traditional surgery.
Common elbow problems that can be treated with arthroscopy include bone spurs, cartilage damage, tendon tears, and arthritis. Often times, multiple elbow conditions can be addressed at one time with arthroscopic elbow surgery.
Elbow arthroscopy is an outpatient procedure, which means you don’t have to stay overnight in the hospital. Your surgery time can vary depending on how much repair needs to be done, but can last anywhere from 30 to 90 minutes.
You arrive at the facility about an hour before your actual surgery time and are checked in by our staff. We conduct a brief health check, listen to your heart and lungs and check your blood pressure, pulse, and temperature. We then start an IV to give you fluids and medications.
The anesthesia staff will discuss options for medications during surgery. Often, a monitored anesthetic lets you relax and fall asleep without the effects of a general anesthetic. At the end of your surgery, a local anesthetic is injected into the elbow to help manage initial discomfort.
Once you’re fast asleep in the operating room, your elbow is filled with saline. Saline helps expand your joint, making it easier for your surgeon to move surgical instruments and see tissues. Your surgeon inserts an arthroscope, a tiny camera hooked up to a large computer screen, to magnify the structures in your elbow and see inside your joint.
Once your surgeon can see in the joint, they make another incision to insert their surgical instruments and repair the damaged tissue. While in your elbow, your surgeon will usually fix any repairable damage they find, even if it was not expected. Even MRIs can miss damage in your elbow, but during an arthroscopy, your surgeon can see exactly what is problematic. A Physician’s Assistant often helps your surgeon throughout surgery and understands everything that was done.
After surgery, your surgeon will tell your family what they found and any limitations you may have using your arm. You’ll be placed in a sling the first day and can typically wean from it as you feel ready. Usually, your surgeon will ask you to just rest and recover for a few days after surgery. After that, you may take off the bulky surgical dressing and are allowed to shower.
As you can imagine, it can be difficult to care for yourself after an elbow arthroscopy, and you may need extra help. Your surgeon will tell your family if you have any specific restrictions after surgery.
One to two weeks after an arthroscopy, patients will be seen by either their surgeon or a Physician’s Assistant. They will discuss with you what they found during your surgery, what was done, and your recovery process. Right after surgery, you will be asked to make a fist and use your forearm muscles to increase blood flow and help prevent a blood clot from forming. This is important since your activity level will decrease right after surgery.
On average, it takes most patients four to six weeks before they are back to their daily activities; however, it can take up to six months to a year before they no longer notice any elbow pain.
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Hard Cartilage Damage and Arthroscopic Chondroplasty
Your elbow joint is where your upper arm bone (humerus) and your forearm bones (ulna and radius) meet. The elbow is responsible for not only bending and straightening your arm but also turning your hand palm up and palm down. These bony surfaces are covered by hard cartilage that should ideally be smooth. Defects or flaps in the hard cartilage can cause your elbow to have a painful catch or click, which can limit the motion of your elbow and make it hard to straighten your arm. Relatively small defects can sometimes be polished and smoothed out with gentle motion exercises, like using an arm bike with no resistance. For severe hard cartilage damage, surgical intervention may be required to remove the unstable flap of tissue.
An elbow chondroplasty is an arthroscopic procedure to smooth out damaged hard cartilage. A surgical instrument is used to remove fraying or flapped hard cartilage and smooth down the remaining tissue. After this procedure, you are often placed in a sling for comfort and can begin to wean from this as you tolerate. Your surgeon will tell your family exactly what your restrictions are after surgery.