Arthroscopy - elbow joint

Introduction

Arthroscopy of the elbow joint is not as common as knee and shoulder arthroscopy. There are several reasons for this. The elbow joint does not contain as much space and thus impacts on the ability to orient and manoeuvre, in addition to lying in close proximity to neurovascular structures.  The instruments and technology used are no different from that employed in knee and shoulder arthroscopy.

Position and Access Points

There are several positions used in working with elbow arthroscopy patients:

  1. Lying prone – the preferred position at our clinic. The patient lies on his abdomen, with the limb to be operated on bent at a right angle at the elbow and allowed to hang over the operating table. Once again, we operate bloodlessly, applying the apparatus to the forearm.
  2. Lying supine – the patient lies supine, with the elbow bent 90° and held in a special halter
  3. Side position - the elbow is once again flexed 90° and placed on a special mat

Surgical Access Points

  1. Anterolateral point - lies between the head of the radius and the head of the humerus, 1 cm distal and 1 cm ventral to the radial epicondyle of the humerus. The elbow must be held in 90° flexion.
  2. Anteromedial point - located 1 cm distal and 1 cm anterior to the ulnar epicondyle; both points are used to examine the front section of the joint.
  3. Posterolateral point - situated in the middle of the triangle described by the olecranon, the dorsal section of the head of the radius and the radial epicotyl, this point is used to examine the back of the joint
  4. Rear central point - lies 1 cm above the top of the olecranon and is accessed when the elbow stretched

Indications

  • treatment of cartilage and removal of free bodies
  • synovectomy
  • osteoarthritis
  • post-traumatic conditions