Elbow Surgery: Arthroscopy

Arthroscopy is a surgery that uses a small camera to look inside a joint. The camera and surgical instruments are the width of a pencil and fit through tiny incisions. Most people have heard of arthroscopy for the knee and shoulder joints. Arthroscopy can also be used as an elbow surgery to treat many conditions of the elbow joint.

The elbow is the joint that connects the upper arm bone and the forearm bones (Figure 1). The incisions used for elbow arthroscopy are smaller and disrupt less soft tissue compared to regular open surgery. Therefore, pain, swelling and stiffness are less, and recovery is often faster.

When is elbow arthroscopy performed?

After talking to you, doing a physical examination, and reviewing your x-rays and other studies such as CT or MRI scans, your surgeon may recommend an arthroscopy for treatment of your elbow disorder. There are a variety of conditions for which elbow arthroscopy can be useful, including:

• Elbow injuries
• Loose pieces of bone or cartilage in the joint
• Fractures
• Elbow arthritis with bone spurs
• Elbow joint inflammation or infection
• Tendonitis such as tennis elbow
• Stiffness

Loose bodies are pebbles of bone or cartilage that cause clicking, catching, or locking of the elbow. They can result from a previous injury, arthritis, or other conditions that affect cartilage. Loose bodies can be removed during arthroscopy.

Your surgeon may use arthroscopy to repair a broken elbow bone. Fractures (broken bones) and other elbow injuries can lead to stiffness or loss of movement. Stiff elbows can be released with elbow arthroscopy.

For patients with arthritis or wear and tear of the cartilage, arthroscopy can be used to remove bone spurs. Although arthroscopy does not cure arthritis, it can improve symptoms and function.

How is elbow arthroscopy performed?

The procedure is performed under general or regional anesthesia. A fiberoptic camera is inserted through a small incision near the elbow. The camera lens shows the small structures in the elbow joint on a television monitor, allowing the surgeon to diagnose the elbow condition. The surgeon makes additional small incisions around the elbow. Through these other portals, the surgeon can place thin instruments or reposition the camera (Figure 2). Sometimes, arthroscopy is combined with an open surgical procedure.

Recovery

After your arthroscopy, you may be placed into an elbow splint or cast that still allows you to use your shoulder and hand. The amount of time in the splint will vary depending on what was performed at the time of surgery. Sometimes, a splint is not used, and elbow movement can start early. Elevating the arm is important to minimize swelling and pain after your surgery. Certain conditions require that you begin physical therapy right away, and others may not require it at all. This procedure usually allows the patient to go home the same day.

Risks and limitations

As with any surgery, elbow arthroscopy has risks. These include infection and potential damage to nerves and arteries. Most nerve injuries are temporary. Elbow stiffness may need to be addressed through physical therapy. Elbow arthroscopy is not appropriate for all elbow conditions and is dependent on the surgeon’s training and expertise. Your surgeon will explain what degree of benefit you might expect from the procedure.

© 2023 American Society for Surgery of the Hand

This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand. Find a hand surgeon near you.