Elbow arthroscopy

Why do I need an elbow arthroscopy?

If you have had a history of ongoing pain and or locking in your elbow you may be a good candidate for arthroscopy.  This procedure allows the surgeon to look inside your elbow joint and evaluate the surfaces and structures of the elbow joint and assess what is causing your symptoms. There can be many causes of pain and or locking in the elbow including loose bodies, arthritis and cartilage damage/tears.

Possible associated procedures?

When the surgeon has assessed your elbow it may be necessary for him to perform one of the following procedures. (He will discuss this with you before your operation);

• Removal of inflamed tissue -this is called a debridement
• Biopsy
• Removal of loose bodies
• Trimming or repairing torn cartilage
• Release of contracture (if your elbow if very stiff)

What are the risks of having an Elbow Arthroscopy?

All operations involve an element of risk, these are very small but you need to be aware of them and can discuss them with your doctor at any time.

• Complications relating to the anaesthetic
• Infection (Less than 1%),
• Neuroma (Less than 1%)

• Injury to nerves of the forearm and hand as the arthroscopy is introduced (less than 5%).

What sort of anaesthetic will be given to me?

You will be given a general anaesthetic. General anaesthesia is drug-induced unconsciousness: it is always provided by an anaesthetist, who is a doctor with specialist training.
Unfortunately, general anaesthesia can cause side effects and complications. Side effects are common, but are usually short-lived: they include nausea, confusion and pain. Complications are very rare, but can cause lasting injury: they include awareness, paralysis and death.
The risks of anaesthesia and surgery are lower for those who are undergoing minor surgery, and who are young, fit, active and well.
You will be given an opportunity to discuss anaesthetic options and risks with your anaesthetist before your surgery.

The day of your operation

• This is a day case procedure i.e. admission and discharge on the same day.

• If you are on regular medication, you will be told to take this if necessary.

• A nurse and porters will take you to the operating theatre.

• Your dentures, glasses or hearing aid can stay with you on your journey to the operating theatre.

• When you arrive in the waiting area, a theatre nurse will check your details with you. You will then be asked to put on a disposable hat. The ward nurse will then leave you and you will then be taken to the anaesthetic room.

What should I expect after my operation?

• After your operation you will be kept in the theatre recovery room before being transferred to the ward.

• A nurse will check your pulse, blood pressure, and breathing rate regularly.   It is important that if you feel any pain you must tell the nursing staff, who can give you painkillers to help.

• The nursing staff will also advise you when you can start taking sips of water. Anaesthetics can make some people sick. If you feel sick we advise you not to drink until this feeling has passed. The nursing staff may offer an injection to help this sick feeling go away.

Going Home

Your doctor will normally discharge you on the same day as your surgery.  You will remain in a sling for approximately one week to rest the elbow. For recreational tennis it is usual to start easy stokes 6 to 12 weeks after surgery.

Discharge Information

Pain relief & medication
The nursing staff will advise you about painkillers before you leave the hospital. Please tell the nurses what painkilling tablets you have at home.

Your wound
Your wounds must remain covered with dressings until your outpatient appointment, where your sutures will be removed.

Getting back to normal
Remember that you have just had an operation. It is normal to feel more tired than usual for a few days after having an operation.
Your shoulder is likely to be uncomfortable in the first few days post-surgery. This is normal but can be helped by:

• Using ice on your elbow for 15 minutes, 2 times per day or after exercise and therapy. Gel packs, frozen peas or a plastic pack of ice can be used. These must be wrapped in a moist towel as direct contact with the skin can cause burns (cover your dressings with cling film or a plastic bag to prevent them getting wet). 
  
• Sleeping can be uncomfortable if you try and lie on your operated arm. We would recommend that initially you lie on your back or on the opposite side. If you lie on your back support the operated arm with a folded pillow under your lower arm. Make sure that your elbow is above your shoulder. If you are on your side then a folded pillow supports your operated arm from your elbow to your wrist.

• Posture can make a significant difference to your pain post surgery. Avoid 'hitching' your shoulder or holding it in an elevated position. Also try to avoid slumping or standing/sitting with round shoulders.

Your physiotherapist will give you further guidance to optimize your recovery. Rehabilitation is an essential component of your recovery to reeducate the serratus anterior muscle.