Elbow Surgery

Elbow Arthroscopy

Elbow arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your elbow joint. The arthroscope is inserted through a small incision (cut) in your skin.

What happens during the procedure?

First, we examine your elbow with the arthroscope. Then we:

  • Insert the arthroscope into your elbow through a small incision. The arthroscope is connected to a video monitor in the operating room.

  • Inspect all the tissues of your elbow joint and the area above the joint -- the cartilage, bones, tendons, and ligaments.

  • Repair any damaged tissues.

At the end of the surgery using the arthroscope, your incisions will be closed with stitches and covered with a dressing (bandage).

Epicondylitis (Tennis Elbow)

Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. Not surprisingly, playing tennis or other racquet sports can cause this condition. But several other sports and activities can also put you at risk.

Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.

There are many treatment options for tennis elbow. In most cases, treatment involves a team approach. Primary doctors, physical therapists, and, in some cases, surgeons work together to provide the most effective care.

Cubital Tunnel Syndrome (Ulnar Nerve Entrapment)

Cubital Tunnel Syndrome occurs when the ulnar nerve in the arm becomes compressed. When this happens, the nerve does not function normally.

It is not known exactly what causes compression of the ulnar nerve. Some factors can make it more likely that the nerve will be compressed. These include:

  • Prior fractures of the elbow
  • Bone spurs
  • Swelling of the elbow joint
  • Cysts

A direct blow to the inside of the elbow, leaning on the elbow for prolonged periods, or repetitive activity that requires a bent elbow can irritate the nerve if it is already compressed

Biceps Tendon Repair

The biceps muscle is in the front of your upper arm. It helps you bend your elbow and rotate your forearm. It also helps keep your shoulder stable.

Tendons attach muscles to bones. Your biceps tendons attach the biceps muscle to bones in the shoulder and in the elbow. If you tear the biceps tendon at the elbow, you will lose strength in your arm and be unable to forcefully turn your arm from palm down to palm up.

Once torn, the biceps tendon at the elbow will not grow back to the bone and heal. Other arm muscles make it possible to bend the elbow fairly well without the biceps. However, they cannot fulfill all the functions, especially the motion of rotating the forearm from palm down to palm up. This is called supination. Significant, permanent weakness during supination will occur if this tendon is not surgically repaired.

Biceps tendon tears can be either partial or complete.

  • Partial tears. Many tears do not completely sever the tendon.
  • Complete tears. A complete tear will split the tendon into two pieces.

In most cases, tears of the distal biceps tendon are complete. This means that the entire muscle is detached from the bone and pulled toward the shoulder. Distal biceps tendon rupture is equally likely in the dominant and non-dominant arm.

Other arm muscles can substitute for the injured tendon, usually resulting in full motion and reasonable function. Left without surgical repair, however, the injured arm will have a 30% to 40% decrease in strength, mainly in twisting the forearm (supination).

Rupture of the biceps tendon at the elbow is unusual. It occurs in only one to two people per 100,000 each year, and rarely in women.

Total Elbow Replacement

Elbow joint replacement is surgery to replace a elbow joint with an artificial joint. The artificial joint is called a prosthesis.

What happens during total elbow replacement surgery?

You may receive general anesthesia before this surgery. This means you will be unconscious and unable to feel pain. Or, you may have a spinal or epidural anesthesia. In this kind of anesthesia, medicine is put into your back to make you numb below your waist.

After you receive anesthesia, your surgeon will make an incision (cut) over your elbow to open it up.

  • Your surgeon will remove the sections of the humerus and the ulna that make up your elbow joint. Any damaged tissue will also be removed.
  • Then your surgeon will drill out part of the center of the humerus and ulna. An end of the artificial joint stems will be inserted into each bone.
  • Usually, bone cement is used to hold the stems in place.
  • Next, your surgeon will attach the 2 stems together with the hinge.
  • Your incision will be closed with sutures (stitches). It will be bandaged, and your arm may be placed in a splint to keep it stable.

Usually, artificial elbows have metal parts. Now, though, some surgeons are using some different materials, including metal on metal, ceramic on ceramic, or ceramic on plastic.

Fractures (Radius, Ulna)

When you bend your elbow, you can easily feel its "tip," a bony prominence that extends from one of the lower arm bones (the ulna). That tip is called the olecranon (oh-lek'-rah-nun). It is positioned directly under the skin of the elbow, without much protection from muscles or other soft tissues. It can easily break if you experience a direct blow to the elbow or fall on a bent elbow.

A patient with an olecranon fracture will typically go to the emergency room because the elbow will be very painful and unable to move.