Elbow arthroscopy is a minimally invasive surgical procedure that allows visualization and treatment of various elbow pathologies through small incisions. This technique provides excellent visualization of intra-articular structures while minimizing soft tissue trauma. The procedure is indicated for removal of loose bodies, treatment of osteochondritis dissecans, synovectomy, management of lateral epicondylitis, contracture release, debridement of osteoarthritis, treatment of rheumatoid arthritis, fracture management, and diagnostic evaluation.
The procedure requires either lateral decubitus or prone positioning, with arm support and pneumatic tourniquet application. Joint distention is achieved with saline, and standard arthroscopic equipment is utilized. Portal placement includes anterolateral, anteromedial, posterior, posterolateral, and direct lateral (as needed) approaches.
Important anatomical considerations include careful identification of neurovascular structures, protection of the ulnar nerve, awareness of capsular attachments, and recognition of ligamentous structures. The technique involves systematic examination of the anterior compartment, posterior compartment, radiocapitellar joint, and ulnohumeral joint, followed by joint distention, portal establishment, diagnostic arthroscopy, therapeutic intervention, and closure.
Potential complications include neurovascular injury, infection, compartment syndrome, portal site problems, joint stiffness, and heterotopic ossification. Post-operative care involves early range of motion exercises, pain management, gradual return to activities, physical therapy as indicated, and regular follow-up.
The procedure offers advantages such as minimal soft tissue disruption, enhanced visualization, faster recovery, reduced post-operative pain, smaller incisions, and earlier rehabilitation. Limitations include technical complexity, a learning curve, equipment requirements, and limited access to certain pathologies. Success rates depend on patient selection, underlying pathology, surgical technique, post-operative compliance, and rehabilitation protocol.
Elbow arthroscopy remains a valuable surgical technique that provides effective treatment for various elbow conditions while minimizing surgical trauma, with optimal outcomes dependent on proper patient selection, meticulous surgical technique, and appropriate post-operative care.
