What is elbow arthroscopic surgery?

Arthroscopy is a way to find problems and do surgery inside a joint without making a large cut (incision). Your doctor puts a lighted tube with a tiny camera and surgical tools through small incisions. The camera is called an arthroscope, or scope.

This surgery can treat several problems.

• For osteoarthritis, the doctor smooths rough surfaces of the elbow bones. The doctor may take out bone spurs or scar tissue.
• For an elbow that does not move easily or that feels like it locks, the doctor may take out or put back in place loose bone or cartilage.
• For "tennis elbow" or other problems, the doctor may cut tissue that is thick or too short. This surgery is called a release.
• For a stiff elbow, the doctor may cut tissue that is thick or too short. This helps your elbow move better.

You probably will go home on the day of the surgery or the next day. Your arm may be in a sling. You may need to do physical rehabilitation (rehab) exercises for several weeks.

You may need about 6 to 8 weeks to recover. But if you had treatment for a stiff elbow, you may need to wear a brace and do rehab exercises for 3 to 6 months. You may have to limit your activity until your elbow strength and movement improve.

If you have a desk job, you may be able to go back to work a few days after the surgery. If you lift things or do physical labor at work, it may be 1 to 2 months before you can go back.

After surgery and rehab, you will probably have less pain and more movement in your elbow. Some people have to avoid lifting heavy objects.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover. Use pillows to raise your elbow and arm above the level of your heart.
• Your doctor or other health professional will tell you how often and how much you can move your elbow and arm.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• You may have a sling for comfort. Start to move your elbow as soon as you can, unless your doctor has told you not to. This will help keep your elbow from getting stiff after surgery.
• For the first few weeks after surgery, avoid lifting anything that could strain your elbow. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
• If you have a desk job, you will probably be able to go back to work or your normal routine in a few days. If you lift heavy objects or do physical labor at work, it may be 1 to 2 months before you can go back.
• You can take a shower 48 to 72 hours after surgery and clean the incisions with regular soap and water. Do not take a bath or soak your elbow until your doctor says it is okay.
• You can drive when your arm is out of the sling and you can use it well enough to be safe, or when your doctor says you can.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids, unless your doctor tells you not to.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you have dressings over your incisions, keep them clean and dry. You may remove them 24 to 48 hours after the surgery.
• If your incisions are open to the air, keep the area clean and dry.
• If you have strips of tape on the incisions, leave the tape on for a week or until it falls off.

Exercise

• The day after surgery, you can lift your shoulder up and down to keep it loose.
• Move your fingers and wrist as much as your bandages will allow.
• Your doctor or physical therapist will give you exercises as part of a rehab program. Start to move your elbow as soon as you can, unless your doctor told you not to.
• Stop any activity that causes sharp pain. Talk to your doctor or physical therapist about what sports or other exercise you can do.

Ice

• To reduce swelling and pain, put ice or a cold pack on your elbow for 10 to 20 minutes at a time. Do this every 1 to 2 hours. Put a thin cloth between the ice and your skin. If your doctor recommended cold therapy using a portable machine, follow the directions that came with the machine.