Elbow Joint Arthroscopy-
The Procedure Is Performed Under One Of The Following Anesthesia:
- General Anesthesia
- Regional Anesthesia- Brachial or Axillary Nerve Block
- Sedation and Local Anesthesia
1. General Anesthesia
- Skin is prepped after the patient is asleep.
- Skin is prepped with aseptic solution.
- Prep skin covered with sterile drape.
2. Regional Anesthesia-
1. Regional Block- Brachial Plexus Block
- Elbow joint is numbed by brachial plexus block.
- Procedure is performed while patient is asleep.
- Brachial plexus is blocked above clavicle using lidocaine or bupivacaine.
- Brachial plexus is identified by using ultrasound or nerve stimulator.
2. Regional Block- Axillary Nerve Block
- Brachial plexus continues as axillary plexus in axilla.
- Local anesthesia injected around nerves in axilla after general anesthesia or sedation.
- Axillary nerve is identified by ultrasound
- Nerves are blocked with short acting lidocaine or long acting bupivacaine.
Sedation with Local Anesthesia
- This Procedure is also performed under local anesthesia
- Patient is sedated prior to injecting local anesthetics
- Local anesthesia injected are lidocaine and bupivacaine.
- Lidocaine block lasts for 1 to 2 hours and bupivacaine block last for 2 to 4 hours.
- The skin is marked for entry point over the back of elbow joint
- Marking is done for entry of the arthroscope and irrigation cannula
- Arthroscope is inserted in to the elbow joint
- Joint is irrigated with normal saline
- Joint is examined through arthroscope.
Elbow Joint Diagnostic Arthroscopy
- Arthroscopy is an examination of elbow joint using arthroscope
- Arthroscope is a tubular telescope which captures live image
- Arthroscope is Pencil size optical device
- Images are displayed on television screen
- Arthroscope images are large in size
- Details are magnified and easy to observe.
The Following Elbow Joint Problems are Diagnosed Using Arthroscope:
- Loose Bodies in Elbow Joint
- Bone Spurs in Elbow Joint
- Loose Elbow Joint Capsule
- Cartilage Damage
- Tendon Tear or Tennis Elbow
- Ligament Tear
1. Loose Bodies in Elbow Joint
- Single or several loose bodies are found in elbow joint
- Loose bodies causes joint pain and stiffness
- Loose bodies also damages cartilage and synovial membrane
2. Bone Spurs in Elbow Joint
- Bone spur causes irritation and tear of ligament and capsule located around spur.
- Bone spur causes pain and joint stiffness.
3. Loose Elbow Joint Capsule
- Loose Elbow joint capsule cause Joint pain and joint subluxation
- Loose capsule is often found over portion of the joint and not complete joint
- Loose capsule is difficult to diagnose with X-Ray and MRI.
4. Cartilage Damage
- Smooth surface of cartilage become rough following cartilage damage
- Cartilage damage breaks into loose fragments in the joint
5. Tendon Tear or Tennis Elbow
- Tear of the elbow joint are difficult to see in X-Ray and MRI
- Tendon tear as in tennis elbow are better observed using arthroscope
- Tendon tear repair can be done following diagnostic block.
6. Ligament Tear
- Ligament tear is difficult to diagnose with clinical examination and X-Ray or MRI
- Arthroscopy of elbow joint assist in diagnosing elbow joint tendon injury.