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Elbow Arthroscopy
Elbow arthroscopy is keyhole surgery of the elbow. Arthroscopy is a minimally invasive surgical procedure (key hole) in which an examination and sometimes treatment of damage of the interior of a joint is performed using an arthroscope. Elbow arthroscopy can be used to examine, diagnose and treat a number of different conditions inside the joint including:
- Arthritis
- Inflammation
- Loose fragments
- Acute or chronic injury
- Damaged tissues or ligaments
- Damaged cartilage
- Pain
- Joint weakness
Above: Strengthening exercises for the muscles and connective tissue around the elbowElbow Arthroscopy Procedure
Arthroscopic surgery of the elbow is usually carried out under a general anaesthetic. The instrument used during an arthroscopy is called an arthroscope (a small telescope) which is connected to a television screen. The arthroscope is inserted through a small incision (10mm) in the back of your elbow. This allows the surgeon to access a clear image of the inside of the elbow and assess the extent of any damage. Once the extent of the damage has been determined further small incisions may be made to allow various specialist instruments to be inserted into the joint to trim and repair the damaged areas. During the operation a sterile solution is placed within the elbow joint to allow the optics of the arthroscope to work to a maximum advantage. At the end of the operation the elbow joint is washed out and the incisions closed Local anaesthetic is instilled into the elbow to provide pain relief in the immediate post-operative period.
Arthroscopy of the elbow is crucial in the treatment of various conditions and is effective in treating symptoms such as chronic pain, stiffness, inflammation and reduced function within the elbow joint.
Above: Passive stretches and mobilisations of the elbow by MSK therapistPhysiotherapy prior to elbow arthroscopy
It is important to undergo physiotherapy prior to your elbow arthroscopy to fully prepare your elbow for the surgery and to assist you in a problem free and rapid recovery once you have undergone elbow arthroscopy. Your physiotherapy programme with Physio.co.uk prior to your elbow arthroscopy will primarily involve controlling any pain and swelling you may be experiencing as well as focusing on strengthening the muscles around your elbow. Your physiotherapy will also aim to maintain your cardiovascular fitness and range of movement as much as possible.
Symptoms after elbow arthroscopy
Immediately after you have had your elbow arthroscopy you should experience minimal pain, swelling and stiffness. You will not regain full range of movement in your elbow straight away and your arm will feel considerably weak. Initially, a compressive dressing is wrapped around your elbow and you will be instructed to start using the elbow as tolerated. Your elbow will need to be kept elevated when not in use for the first day to decrease swelling. You will be required to maintain range of motion and you will be placed on a CPM (continuous passive motion) machine the same day. Physiotherapy will begin immediately after your surgery to regain full range of movement as soon as possible.
Arthroscopy is carried out mainly as a day case procedure and therefore if no complications occur it is likely you will be home as soon as you’re ready, you will experience little pain and recovery will be rapid. You may be given an arm sling to use when out and about to protect your elbow from further damage. You will not be able to drive immediately after arthroscopy but you can return to driving between 2 and 5 days providing there has been no complications and the elbow is pain free.
Above: Soft tissue massage of the the connective tissues around the elbowPhysiotherapy after arthroscopy
It is crucial to begin a comprehensive physiotherapy programme as soon as you have had elbow arthroscopy. A personal physiotherapy programme with Physio.co.uk will ensure that the surgery is fully successful, prevent the likelihood of any problem and quicken the return of full function in your elbow. As elbow arthroscopy is a fairly uncomplicated procedure, and as long as you commit to your physiotherapy programme, recovery should be rapid. Following a successful surgery and physiotherapy course with Physio.co.uk, you will regain painless, full function in your elbow within 2-3 months after the surgery.
Post-Op 1-7 days
In the first week after your surgery, your physiotherapy programme with Physio.co.uk will mainly focus on controlling any pain and swelling that you will be experiencing. Your physiotherapy will also aim to reduce stiffness whilst also regaining some of the range of movement in your elbow. Your physiotherapy will include:
- Cryotherapy (ice)
- Pain modalities
- Shoulder, wrist and hand active range of movement exercises
- Elbow passive range of movement exercises
- Mobility exercises for upper limb i.e. shoulder shrugs
1-4 weeks
After a week of physiotherapy post elbow arthroscopy, the goals of your physiotherapy course with Physio.co.uk will focus on the continuation of modalities for pain and swelling and improving the range of movement in your elbow. The goals of your physiotherapy will also include increasing the strength in the muscles in and around your elbow and improving muscle control and function. Your physiotherapy at this time will include:
- Cryotherapy
- Use of sling when out and about for protection (not necessary all the time)
- Passive range of movement exercises for elbow and wrist (bending, straightening, twisting)
- Progression to active range of movement exercises
- Isometric (hold) strengthening exercises for muscles around elbow joint (pronator teres, supinator, brachioradialis, biceps, triceps)
- Hand squeezing exercises (putty/sponge)
- Upper limb mobility exercises
- Stretching exercises to increase flexibility
- Strengthening exercises for muscles in wrist, hand and shoulder
- Activities for opposite arm
5-8 weeks
After the first month of your rehabilitation with Physio.co.uk your physiotherapy will focus on the continuation and progression of activities from previous weeks. The main goals of your physiotherapy programme at this point will be to continue to increase the strength, range of movement, flexibility and function in your affected arm. Goals will also begin to focus on improving your overall cardiovascular fitness and muscle endurance in the muscles around your elbow. Your physiotherapy will include:
- Continuation of modalities to control pain and swelling (if applicable)
- Active range of movement exercises (bending, straightening and twisting elbow joint)
- Active strengthening exercises for muscles in and around elbow
- Strengthening, stretching and range of movement exercises for wrist and hand
- Strengthening, stretching and range of movement exercises for shoulder
- Activities for opposite arm
- Arm cycle
- Hydrotherapy
9-12 weeks
In the third month of your rehabilitation post elbow arthroscopy, your physiotherapy programme with Physio.co.uk will aim to continue the improvement seen in the exercises from previous weeks. Your physiotherapy will include:
- Continuation of strengthening, stretching and range of movement exercises for muscles in elbow
- Continuation of strengthening, stretching and range of movement exercises for wrist, hand and shoulder of affected arm and also equivalent exercises for opposite arm
- Arm cycle (resistance as tolerated)
- Hydrotherapy
The success and rate of your recovery after elbow arthroscopy highly depends on your commitment and adherence to the comprehensive physiotherapy programme provided by Physio.co.uk as well as the initial condition of your elbow prior to your elbow arthroscopy surgery.
Above: Passive stretch of muscles and connective tissue of the uppper armSummary
Elbow arthroscopy can be used to examine, diagnose and treat a number of different conditions inside the elbow joint such as osteoarthritis, damage, injury and many other conditions that affect the elbow joint. It is important to undergo elbow arthroscopy to significantly relieve symptoms caused by problems within the elbow joint and consequently improve elbow function. Elbow arthroscopy involves inserting a small instrument called an arthroscope into the elbow joint. Specialist instruments can be attached to the arthroscope to examine and further treat any damage or conditions within the joint. A comprehensive physiotherapy programme with Physio.co.uk is crucial after elbow arthroscopy surgery to ensure the success of the operation, guarantee the return of full function and prevent any future problems occurring within the elbow. Furthermore, physiotherapy with Physio.co.uk will help you achieve a full and rapid return of function in your elbow so that you can get back to you everyday tasks, hobbies, job and even sport. Call Physio.co.uk now on 0330 088 7800 for more information or to book an appointment please contact us.
