How is the procedure performed?
The procedure is performed under a combination of general and regional anaesthesia. An arthroscope is inserted into the joint after distending it with saline. The inside of the joint is examined. Any associated problems in the joint are treated at this stage. The capsule on the lateral side of the joint is opened with the aid of a radiofrequency probe to expose the affected tendon (the Extensor carpi radialis brevis), which is released from its origin from the bone. The exposed bone surface is then treated by drilling, abrasion or microfracture.
The main benefit of the procedure is to relieve pain, which in turn allows an improvement in the function of the elbow. More than 90% of patients achieve benefit from surgery.
Pain - The elbow may be painful for some days after surgery. This is usually managed by taking appropriate pain relieving medication and activity modification.
Swelling – During the procedure, the joint is distended with saline and this may lead to the elbow remaining swollen for a day or two after surgery. You should keep the arm elevated after surgery for 5-7 days.
Bleeding – A small amount of bleeding from the arthroscopy portal sites is not unusual and will usually settle after a day or two.
Stiffness – This may occasionally occur after any form of elbow surgery. Prevention is the key and it is essential to follow the instructions provided, perform daily stretching and exercises at home to maintain the range of movements.
Infection – Infection is a possibility but rare after arthroscopic surgery.
Persistent drainage – Discharge of fluid from the portal sites may occur following surgery but will usually stop within a few days. Persistent drainage is rare but may suggest infection and you should seek attention immediately.
Nerve injury – Injury to the nerves around the elbow is possible but rare. This may result in temporary numbness or weakness around the hand, wrist or forearm. Permanent nerve injuries are extremely rare.
Following the procedure the arthroscopy portal sites (skin incisions) will be closed with tape or sutures and covered with shower-proof dressings. These dressings should be left undisturbed as far as possible for 5-7 days. If the dressings are removed for any reason they should be replaced with similar dressings or waterproof plasters. A compression bandage is applied after surgery and will usually be removed the next day. A sling will be provided to support the arm, but may be removed as tolerated to move the arm and is usually discarded after 2-3 days. A physiotherapist will provide instructions about mobilising the elbow prior to discharge from hospital. Outpatient physiotherapy may occasionally be recommended but is not always necessary. You may resume driving after 5-7 days. If the portal wounds have been closed with sutures, these are removed after 10-14 days.
An appointment will be arranged for you in the outpatient clinic within two to four weeks after the procedure. Follow-up is required for at least 3-6 months after surgery or until a satisfactory recovery is achieved. Strenuous tasks should be avoided for 6-8 weeks. Sports activities may gradually be resumed after 12 weeks.
Information on rehab can be found here.