Patient Information
ELBOW ARTHROSCOPY
Elbow arthroscopy is a surgery method that enables the diagnosis and treatment of injuries
and diseases of the elbow joint with the minimum invasion. The surgery is performed under
a general anaesthesia. Similar to an arthroscopy of other joints, the elbow arthroscopy also
involves the insertion of an endoscopic optical instrument into the joint via a small
cutaneous incision. The camera on the endoscope projects an enlarged image of the inside
of the joint onto a display and thus enables the surgeon to examine all the anatomical
structures inside the joint and in its immediate vicinity.
Due to the vicinity of numerous nerves and blood
vessels in the elbow, elbow arthroscopy is a relatively
complex procedure that, providing the surgeon is
experienced, is nonetheless safe and has numerous
advantages over classical surgical procedures. Elbow
arthroscopy has established itself only in the last few
years. It is most often used in treating the so called
tennis elbow, early degenerative changes to the elbow,
injuries of cartilaginous surfaces, posterolateral plica,
certain forms of instabilities of the elbow joint, chronic
contractures in the elbow and chronic synovitis, which
is usually present in the event of rheumatoid arthritis
of the elbow.
The Elbow Arthroscopy Procedure
An elbow arthroscopy is a surgery procedure performed under general anaesthesia. To
perform a diagnostic arthroscopy, four cutaneous incisions are required, each 0.5-1 cm in
length. The first two are used to examine the anterior of the elbow joint with a camera and a
sensor. The second part involves a diagnostic arthroscopy by inserting the camera and
sensor into the posterior of the elbow joint via the other two cutaneous incisions. Similar to
the knee arthroscopy, the elbow joint is filled with sterile lactated Ringer’s solution during
the procedure. This is a special solution of water and electrolytes that is used to rinse out
the joint, somewhat expand it and thus enable good visibility of the inside of the joint.
An elbow arthroscopy is usually performed in two steps. The first part of the procedure
involves inserting the arthroscope into the anterior of the joint and examining the joint
surface of the anterior of the humerus, the anterior joint capsule and the joint between the
radius and the humerus. Arthroscopy is then continued by examining the posterior cubital
fossa and the posterior of the joint surface of the humerus, the ulna and the radius. During
this diagnostic examination of the joint, degenerative or injury changes to the cartilaginous
surfaces of the joint, loose fragments in the joint, bone resulting from advanced
degenerative changes, a thickened joint capsule, abnormal synovial membrane and signs of
of joint instability and looseness of ligaments can be identified.
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During the elbow arthroscopy, the planned surgical procedure is carried out depending on
the type of injury or disease. Thus, early degenerative changes in the joint can be treated by
smoothing the joint surfaces, limited joint mobility can be treated by releasing the overly
thickened joint capsule, chronic joint swelling as a part of rheumatic diseases can be treated
by removing the synovial membrane, issues related to epicondylitis can be treated by
removing the damaged section of the radial extensor tendons, loose fragments in the joint
can be removed and other conditions in the joint can also be treated.
Depending on the extent and complexity of the procedure, the surgery can last from 20
minutes to two hours. After the procedure, the patient spends a short time lying in the
awakening room and is then released into home care on the same day.
The Advantages of Invasive Arthroscopic Elbow Procedures
Arthroscopic surgery methods that enable the treatment of joint injuries or diseases with
minimal invasion have many advantages over classic surgery procedures. In the elbow joint,
arthroscopy enables a more comprehensive examination of the entire joint and the display
of numerous anatomical structures that are not accessible with classic surgery procedures.
Preserving the integrity of the periarticular muscles during arthroscopic procedures is also
related to less pain during the postoperative period, there is no scarring and adhesion that
can generally occur between the muscles and the joint capsule. Arthroscopic surgery
procedures on the elbow also have a significantly lower risk of postoperative superficial and
deep infections of the joint. The risk of excessive bleeding occurring is also lower. Last but
not least, because the cutaneous incisions are tiny, the cosmetic effects of the surgery are
also significantly better.
Indications for an Elbow Arthroscopy
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Chronic synovitis with joint swelling
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Epicondylitis (tennis elbow)
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Limited elbow mobility
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Moderate degenerative changes
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Issues related to radial plica
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Damage to the joint surface of the
radius
Loose fragments in the joint
Limited damage to the cartilaginous
surface
Unexplained pain in the joint
Rehabilitation after an Elbow Arthroscopy
Due to the minimal invasiveness, rehabilitation after arthroscopic procedures is faster and
easier in many ways than after classic surgery procedures. After such a surgery, there is less
pain and in some cases the joint function is also restored faster. The actual time of recovery
depends on the type of procedure performed and is relatively short for simple procedures
such as removing loose fragments or smoothing degenerative bone changes on the edges of
joint surfaces. Rehabilitation is longer after more complex procedures such as joint
synovectomy, surgery for tennis elbow or releasing a thickened joint capsule by smoothing
the joint surface as part of treating moderate to advanced degenerative changes in the
elbow joint. Rehabilitation after such procedures usually lasts 4 to 6 months. You should
also be aware that whenever degenerative changes are already present in the joint, this
contributes to a much longer time required for the rehabilitation process and also leads to a
less favourable end result of such a treatment.
Directly after the surgery, the elbow has to be cooled several times per day with ice, which
decreases the swelling of the joint and also eases the pain. After the patient is released, we
prescribe a suitable analgesic therapy and the patient also receives instructions regarding
activities they are allowed to perform with the affected arm. During the first days after the
surgery, resting the arm is generally recommended. After the pain subsides, the patient can
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start gradually using the arm for everyday tasks. At the check-up after the surgery, an
individual programme of physical therapy is prescribed that is adapted to the individual
and the type of procedure performed.
Risks and Complications Related to Elbow Arthroscopy
As with all surgical procedures, the elbow arthroscopy can also lead to complications,
though in the majority of cases these are extremely rare due to the minimum invasiveness
of the procedure. Compared to other arthroscopic procedures, elbow arthroscopy is
somewhat more risky due to the immediate vicinity of several nerves that run through the
joint itself and that might be damaged during the procedure. Despite the above, with
suitable surgical technique, such damage to the nerves is extremely rare, but nonetheless
possible. The consequences of this damage can be a temporary loss of the sense of touch or
the active mobility of a certain part of the arm. Such damage can also be permanent.
The following risks and complications exist during such procedures:
 Bacterial contamination of the wound
 Bacterial contamination of the joint
 Bleeding into the joint
 Long-term swelling and pain in the joint
 Breakage of instruments in the joint
 Injury to nerves and blood vessels near the joint
 Blood clots, consequently also emboli (lodging of a blood clot in the blood vessel)
 Wounds on the skin and compression damage to nerves due to pressure against the
operating table
 Allergic reactions to medication
 Failure of the technical equipment used to perform the surgery
 Exceptionally, the above mentioned complications can lead to the need for
additional surgery procedures or to convert the arthroscopic procedure into the
classic surgery.
Preparation before Surgery
A week before the planned surgery, basic lab tests (blood count, electrolytes, PT, INR) have
to be performed at a general practitioner. Patients older than 40 and everyone with any
accompanying chronic diseases additionally need a chest x-ray and an EKG.
Changes to the general health condition can affect the performance of the surgery, therefore
in the event of the following conditions, immediately notify the doctor that ordered your
surgery:
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symptoms of cold
increased body temperature
irritation in the eyes, ears, throat, palms or dental issues
lesions, cuts or wounds on skin
gastrointestinal diseases with problems such as nausea, vomiting, stomach pain,
diarrhoea, blood in the stool
renal and urinary disorders with problems such as a burning sensation during
urination, kidney cramps, very frequent urination, blood in urine
if there is a possibility you are pregnant.
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When arriving for the surgery, you should have all your existing medical documents with
you, including all images, and a signed consent form for performing the proposed surgery
procedure. For minors, the surgery consent should be signed by the parents or caretakers.
Before the surgery, the doctor should be urgently informed about any possible known
allergies or sensitization to medication. For minors, the surgery consent should be signed by
the parents or caretakers. Before the surgery, the doctor must be informed about all the
medication you are regularly taking.
IMPORTANT INSTRUCTIONS BEFORE THE SURGERY:
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Consuming food or drink at least 6 hours before the planned surgery is not allowed.
On the day of the surgery, intensively wash the elbow for at least 5 minutes with
soap during showering.
On the day of the surgery, take all your regular medication, unless you receive
different instructions from the doctor.
Do not attend the surgery wearing make-up, remove any nail polish from your nails.
Wear comfortable clothes that are easy to take off and put on.
If you have crutches or a brace that you have been using, take them with you.
We ask that you leave all your jewellery, any watch and other valuable objects at
home.
When you leave for home, it is essential that you are accompanied by a person of
legal age, because driving a motor vehicle is not allowed directly after the surgery.
You will be released home on the day of the surgery.
We are available for additional explanation via the phone number 00 386 1 518 7063
and via e-mail: info@artros.si
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