Arthrotomy of the Elbow with Capsular Excision for Capsular Release

Name of the Procedure:

• Common Name: Elbow Arthrotomy with Capsular Excision
• Medical Term: Arthrotomy of the elbow with capsular excision for capsular release

Summary

Arthrotomy of the elbow with capsular excision involves surgically opening the elbow joint to remove part of the joint capsule. This is done to relieve stiffness and improve range of motion in the elbow.

Purpose

• Medical Condition: Elbow stiffness or limited range of motion due to conditions like arthritis or severe trauma.
• Goals: To release the tight joint capsule, thereby increasing the elbow's range of motion and reducing pain.

Indications

• Symptoms: Persistent elbow stiffness, restricted range of motion, pain when moving the elbow.
• Patient Criteria: Patients with limited elbow movement that has not improved with conservative treatments like physical therapy or medications.

Preparation

• Pre-procedure Instructions: Fasting for at least 8 hours prior to surgery, discontinuing certain medications as advised by the doctor.
• Diagnostic Tests: X-rays, MRI, or CT scans to assess the elbow joint's condition.

Procedure Description

1. Anesthesia: General anesthesia or regional anesthesia is administered.
2. Incision: A surgical incision is made over the elbow joint to access the joint capsule.
3. Capsular Excision: Part of the joint capsule is carefully removed to loosen the joint.
4. Additional Steps: Any other necessary repairs to the joint structures may also be performed.
5. Closure: The incision is closed with sutures or staples.

Tools and Equipment: Surgical instruments, imaging devices for guidance, sutures, and anesthesia equipment.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity.

Setting

This procedure is generally performed in a hospital or surgical center.

Personnel

• Healthcare Professionals: Orthopedic surgeon, anesthesiologist, surgical nurses, and operating room technicians.

Risks and Complications

• Common Risks: Infection, bleeding, swelling, and temporary pain.
• Rare Risks: Nerve damage, blood clots, complications from anesthesia, and incomplete relief of symptoms.

Benefits

• Expected Benefits: Improved range of motion in the elbow, reduced pain, and enhanced ability to perform daily activities.
• Realization Time: Benefits are usually noticed within a few weeks to a few months post-surgery.

Recovery

• Post-procedure Care: Pain management with medications, keeping the surgical site clean and dry, and applying ice to reduce swelling.
• Expected Recovery Time: Full recovery might take several weeks; restrictions on heavy lifting or strenuous activities are typically advised.
• Follow-up: Regular follow-up appointments for monitoring and physical therapy sessions to aid in recovery.

Alternatives

• Other Options: Non-surgical treatments like physical therapy, corticosteroid injections, or less invasive procedures.
• Pros and Cons: Non-surgical methods may be less risky but may not be as effective for severe cases. Each alternative has its own set of benefits and limitations compared to arthrotomy with capsular excision.

Patient Experience

• During the Procedure: The patient will be under anesthesia and should not feel any pain.
• After the Procedure: Pain and swelling are common but can be managed with medications. Physical therapy will be necessary to restore mobility, and stepping back into normal activities will be gradual. Comfort measures, such as ice packs and elevation of the arm, can help manage post-operative symptoms.