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 arthroscopically, with your surgeon placing 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, arthroscopic elbow surgery can address multiple elbow conditions at one time.
Elbow arthroscopy can last 30-90 minutes, depending on how much repair needs to be done. It’s an outpatient procedure, which means you don’t have to stay overnight in the hospital.
You arrive at the facility about an hour before your actual surgery time and are checked in by our staff. We have you change into a surgical gown, listen to your heart and lungs, and check your blood pressure, pulse, and temperature. We start an IV to give you fluids and medications, and prep the skin around your surgery site.
The anesthesia staff will meet with you and review your health history, past surgeries, and current medications, and discuss your anesthesia options.
A monitored anesthetic often lets you relax and fall asleep without the effects of a general anesthetic. At the end of 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 to expand the 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.
Once your surgeon can see in the joint, they make another incision to insert their surgical instruments and repair whatever repairable damage they find, even unexpected damage. MRIs can miss damage in your elbow, but during an arthroscopy, your surgeon can see everything that’s problematic. A Physician’s Assistant (PA) 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’ll have using your arm. You’ll be placed in a sling the first day and can typically wean from it as you’re able. Usually, your surgeon will ask you to just rest and recover for a few days after surgery. After that, you can 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. Don’t be afraid to ask for help if you need it.
One to two weeks after an arthroscopy, patients will meet with either their surgeon or a PA to discuss 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 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 smooth, hard cartilage. Cartilage defects or flaps 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. Severe hard-cartilage damage may require surgery to remove the unstable flap of tissue.
An elbow chondroplasty is an arthroscopic procedure that removes fraying or flapped hard cartilage and smooths 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.