Elbow Arthroscopy
Elbow Arthroscopy
Three bones come together to form the elbow. They are the humerus (upper arm bone), the radius (lower arm bone on the thumb side), and the ulna (lower arm bone on the little finger side). These bones form a hinge joint. In addition, the radius rotates so you can turn your palm to the front or to the back. Arthroscopic surgery of the elbow is challenging because of the joint's anatomy. The bones lie close together, and nerves and blood vessels are located very close to the joint (see illustration). Therefore, the doctor must be especially careful when inserting the arthroscopic instruments into the joint.
Although it is a difficult procedure, arthroscopic surgery is often the ideal choice for treating certain elbow conditions. An injury or arthritis can damage the ends of the bones and cause bone spurs to develop. These spurs can be painful and make it hard to move the elbow. The doctor can remove the spurs by using special tools, such as a burr, inserted into the joint through the portals or small incisions. After the spurs are removed, the elbow moves more easily and with less pain.
An injury, such as a fall on an outstretched arm, can tear cartilage and damage bone in the elbow. A piece of loose bone or cartilage can cause the joint to lock. If the loose piece is big, the doctor might be able to put it back in the right place arthroscopically. If the doctor cannot replace the piece, he or she can remove it and smooth the site of the fracture or tear.
You can develop overuse injuries, such as tennis elbow, when you perform the same activity over and over with your wrist and elbow. Repeated activity can irritate the tendons (tissues that attach muscles to bones) in the elbow, causing pain. Usually, the injury improves when treated with rest, ice, and nonsteroidal anti-inflammatory drugs (e.g., aspirin, ibuprofen). However, sometimes it must be treated with surgery, which can be done during an open or arthroscopic procedure.
You usually return to your normal activities more quickly after arthroscopic treatment of an elbow injury than after traditional open surgery. If you must have surgery to treat an elbow problem, ask your doctor whether it can be done with the arthroscope.
David Nedeff, M.D.
Columbus, Georgia
Further Reading: Baker CL, Brooks AA. Arthroscopy of the elbow. Clin Sports Med. 1996;15(2):261-281. Morrey BF. Complications of elbow arthroscopy. Instr Course Lect. 2000;49:255-258.
