Αρθροσκόπηση Αγκώνα

Elbow Arthroscopy

ΠΕΡΙΕΧΟΜΕΝΑ

Modern orthopedic surgery has made tremendous scientific and technological leaps, and elbow arthroscopy is perhaps one of the most characteristic examples of this progress. The elbow is an extremely complex joint with limited space, through which critical nerves and vessels pass. In the past, the surgical approach to this area required large, painful incisions, extensive muscle detachment, and a long recovery period, often accompanied by permanent stiffness.

Today, modern arthroscopic surgery of the 3 joints of the elbow allows the specialized surgeon to treat the vast majority of sports injuries, traumas, and degenerative conditions with impressive precision and minimal inconvenience for the patient.

The Anatomy of the Elbow and the Value of Arthroscopy

To understand the value and difficulty of elbow arthroscopy, it should be mentioned that the elbow is not a simple joint, but a complex of three smaller joints (humeroulnar, humeroradial, and proximal radioulnar joints) surrounded by a common capsule. These joints allow us to bend our arm (flexion/extension) but also to rotate our palm upwards or downwards (pronation/supination).

Due to the narrowness of the space and the proximity to large nerves (such as the ulnar, median, and radial nerves), elbow arthroscopy is considered technically one of the most demanding procedures in Orthopedics. It requires a surgeon with deep knowledge of the three-dimensional anatomy of the area and great familiarity with the use of the arthroscope.

The use of a microscopic high-definition camera (arthroscope) allows the magnification of internal structures, offering the surgeon visibility that often exceeds that of open surgery, while simultaneously protecting sensitive nerves and vessels.

Ο μόνος Ορθοπαιδικός στην Ελλάδα στην χειρουργική ώμου και άνω άκρου με προϋπηρεσία μόνιμης διευθυντικής θέσης (substantive Consultant ) για 10 συναπτά έτη στην Μεγάλη Βρετανία

When is Elbow Arthroscopy Necessary?

Elbow arthroscopy is indicated for both acute injuries and chronic conditions that do not respond to conservative treatment (physical therapy, anti-inflammatory medications, PRP, or cortisone injections). The most common conditions treated with this method are:

  • Removal of Loose Bodies: Small pieces of cartilage or bone that detach after an injury or due to osteochondritis and “lock” the joint, causing severe pain.
  • Arthrolysis for Stiffness (Stiff Elbow): The elbow is the most “sensitive” joint in the body for developing stiffness after fractures, injuries, or prolonged immobilization. Arthroscopically, scar tissue is removed and the capsule is released, restoring movement.
  • Management of Lateral Epicondylitis (Tennis Elbow): In chronic cases where the extensor tendon has undergone degeneration or partial tearing and conservative treatment has failed, arthroscopic debridement offers a definitive solution.
  • Early Osteoarthritis or Rheumatoid Arthritis: Osteophytes (bone spurs) that limit movement are removed and synovectomy (removal of inflamed tissue) is performed, drastically reducing pain.
  • Articular Cartilage Lesions: Debridement of chondropathy areas and bone stimulation (microfractures) to create new tissue.
  • Elbow Instability: In some cases, ligament repair can be assisted or performed arthroscopically.

What are the Symptoms That Should Lead You to the Doctor?

Elbow conditions manifest with clear signs that should not be ignored:

  • Persistent Pain: Pain located in the joint that persists during rest or worsens with movements and daily activities (e.g., lifting an object).
  • Limitation of Movement (Stiffness): Inability to straighten or bend the arm fully, or difficulty rotating the palm upwards.
  • Sensation of “Locking”: The sudden inability to move the elbow at some point in its range of motion, which usually indicates the existence of a loose body.
  • Friction Sounds (Crepitus): Characteristic sounds during movement, accompanied by pain or a feeling of “catching.”
  • Edema (Swelling): Collection of fluid in the joint, visible mainly on the back or outer side of the elbow.

How is the Operation Performed?

Elbow arthroscopy is a procedure performed in an organized hospital environment, usually as day surgery (Day Clinic), allowing the patient to return home a few hours later.

Preparation 

Before the surgery, the necessary preoperative checkup (blood tests, electrocardiogram, chest X-ray) is performed. The patient must fast for 6-8 hours before the procedure.

The Procedure Step-by-Step 

  • Anesthesia: General anesthesia is usually chosen, which is often combined with a regional nerve block so that the arm remains numb and pain-free for several hours after the surgery.
  • Patient Positioning: The patient is placed either in a lateral position or in a prone position (face down), with the arm stabilized in a special positioning device.
  • Portals of Entry (Incisions): The surgeon carefully outlines the anatomical landmarks and nerves. Three to four microscopic incisions (about 4-5 millimeters) are made around the elbow.
  • Joint Distension: The joint is filled with normal saline to expand the space and ensure clear visibility.
  • Insertion of Arthroscope and Instruments: The camera is inserted for the complete inspection of the joint. Through the remaining portals, specialized micro-instruments (graspers, shaver, radiofrequency tools) are inserted to repair the lesion.
  • Closure: At the end, the saline is drained, the small incisions are closed with 1-2 sutures or special adhesive strips, and a soft dressing is applied.

The duration of the operation usually ranges from 30 to 90 minutes, depending on the severity of the problem.

What are the Benefits of the Method?

Compared to old, open approaches, elbow arthroscopy offers invaluable advantages:

  • Minimal Postoperative Pain: Since muscles and tendons are not cut, the pain is extremely mild and easily managed with simple analgesics.
  • Rapid Recovery: The patient mobilizes their arm almost immediately, avoiding the creation of new adhesions and stiffness.
  • Zero Hospitalization: Return home on the same day.
  • Precision and Safety: The magnification of the camera allows the identification and correction of lesions that would be impossible to see otherwise, reducing the chances of complications.
  • Excellent Aesthetic Result: The scars are minimally visible after a few weeks.

Rehabilitation and Return to Activities

Recovery after an elbow arthroscopy starts immediately after surgery. Unlike other joints, the elbow requires early mobilization so that stiffness does not develop.

The First Days

  • The arm is kept elevated to limit swelling.
  • Ice therapy is applied for 15-20 minutes, several times a day.
  • The patient is encouraged to move their fingers and wrist immediately.

Weeks 1-2

  • A specialized physical therapy program begins with passive and active range of motion exercises.
  • Sutures are removed at 10-14 days.
  • Returning to daily activities (washing, eating) and office work is feasible within a few days.

Weeks 3-6

  • The program focuses on fully regaining the range of motion (extension and flexion) and gradual strengthening of the arm and forearm muscles begins.
  • Driving is usually allowed after the first 2 weeks, depending on which arm was operated on and the range of motion.

After 6 Weeks

  • Gradual return to heavy manual labor and sports activities (swimming, running) is permitted. For racket sports (tennis, padel) or weights, 3-4 months may be required, depending on the type of restoration.

Tips for a Safe Recovery

To ensure the optimal result of the operation, follow the instructions below:

  • Consistency in Exercises: Perform the exercises given to you multiple times a day at home. Your own participation is decisive.
  • Protection of Incisions: Keep the incisions clean and dry. Avoid showering without protection until the sutures are removed.
  • No Heavy Objects: Do not lift weights with the operated arm during the first 4-6 weeks.
  • Healthy Lifestyle: A diet rich in proteins and vitamins helps faster tissue healing.

A Few Words About the Doctor (Mr. Polyzois)

The success of an elbow arthroscopy strictly depends on the specialization and experience of the surgeon. Orthopedic Surgeon Mr. Polyzois possesses a unique scientific background that guarantees the safety of the operation.

He is the only Orthopedic Surgeon in Greece specialized in shoulder and upper limb surgery (which includes the elbow and hand) with a permanent directorial tenure (substantive Consultant) for 10 consecutive years in the National Health Service (NHS) of Great Britain. Having performed thousands of successful arthroscopic procedures abroad, he treats the entire spectrum of elbow conditions based on the strictest international medical protocols, offering his patients individualized care and a definitive solution to their problem.

Cost – Prices for Elbow Arthroscopy

The cost of an arthroscopic procedure on the elbow is structured individually for each patient, as it depends on the type of condition and the complexity of the restoration (e.g., a simple loose body removal has different requirements than an extensive arthrolysis for severe stiffness).

In our clinic, we believe that top-tier medical care should be accessible. The total cost is kept at perfectly reasonable and affordable levels. For the financial ease of the patient, there is full cooperation with the public insurance provider (EOPYY), as well as an open line with all private insurance companies. After the clinical examination and the evaluation of imaging tests (MRI), you will receive a complete, transparent, and detailed briefing on all options and the corresponding cost, with no hidden charges.

Do not let pain and stiffness limit your life. Contact the Doctor and his team for a specialized solution to your problem.

Η κIνηση εIναι ζωH!

Επικοινωνήστε με τον γιατρό για εξειδικευμένη ορθοπαιδική φροντίδα, προσαρμοσμένη στις ανάγκες σας

Συχνές ερωτήσεις

What are the greatest risks in an elbow arthroscopy? 

Due to the presence of large nerves (ulnar, median, radial) that pass right next to the joint, the main, though rare, risk is the irritation or transient injury of a nerve. This can manifest as temporary numbness in the fingers or mild weakness. In the hands of a specialized upper limb surgeon, this risk is minimized to the lowest level, as the entry portals are designed with mathematical precision. Other general risks include inflammation (under 0.5%) and persistent postoperative stiffness if physical therapy is not followed correctly.

Will I have permanent restrictions on my movements after the operation? 

No, the goal of arthroscopy is exactly the opposite: the elimination of restrictions and pain. During the initial period of recovery (the first 4-6 weeks), you should avoid lifting heavy weights (over 2-3 kg) and not make intense rotational movements under resistance. However, in the long term, once recovery is smoothly completed, you will be able to use your arm freely, without any permanent functional restriction.

How important is compliance with the doctor’s instructions? 

Compliance is half the way to success. The surgical procedure “corrects” the damage anatomically, but full functional restoration is determined by the faithful implementation of the physical therapy program. Especially in the elbow, which has a huge tendency to develop stiffness after any trauma or surgery, executing stretches multiple times a day, as you will be instructed, is critical so that the joint does not “freeze.”

How can I protect my elbow in the long term? 

Long-term protection is based on the prevention of overuse. It is important to maintain the muscular system of the upper limb in excellent condition (strengthening the muscles of the forearm, bicep, and tricep), so that they absorb the loads and not the joint itself. Also, if you engage in sports such as tennis or padel, correct technique and choosing the appropriate equipment (correct racket grip size, appropriate weight) are of fundamental importance to avoid recurrences.