Name of the Procedure:

Arthrotomy, Elbow; with Joint Exploration, with or without Biopsy, with or without Removal of Loose or Foreign Body.

Summary

An arthrotomy of the elbow is a surgical procedure where an incision is made in the elbow joint to explore, biopsy, or remove any loose or foreign bodies. This can help diagnose or treat conditions affecting joint function or causing pain.

Purpose

The procedure addresses joint issues such as persistent pain, limited mobility, and the presence of loose bodies within the joint space. It aims to relieve symptoms, improve joint function, and provide diagnostic information if a biopsy is performed.

Indications

• Chronic elbow pain unresponsive to conservative treatments.
• Mechanical symptoms like locking or clicking of the elbow.
• Presence of loose or foreign bodies within the joint.
• Suspected joint infection or inflammatory conditions requiring biopsy.

Preparation

• Patients may need to fast for 6-8 hours before the procedure.
• Adjustments to medications, especially blood thinners, as advised by the doctor.
• Pre-operative diagnostic tests such as imaging studies (X-ray, MRI) and blood work.

Procedure Description

1. The patient is given regional or general anesthesia.
2. An incision is made over the elbow joint.
3. The surgeon explores the joint to identify and assess any abnormalities.
4. Loose or foreign bodies are removed, and if necessary, a biopsy is taken from the synovium or other tissues.
5. The joint is irrigated to ensure all loose particles are cleared.
6. The incision is closed with sutures, and a sterile dressing is applied.

Tools: Surgical scalpel, retractors, forceps, irrigation tools. Anesthesia: Regional (nerve block) or general anesthesia.

Duration

Typically, the procedure takes about 1 to 2 hours.

Setting

The procedure is performed in a hospital operating room or a surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurse
• Operating room technician

Risks and Complications

• Infection
• Bleeding
• Damage to nerves or blood vessels
• Stiffness or reduced range of motion in the elbow
• Complications from anesthesia
• Blood clots

Benefits

• Relief of pain and mechanical symptoms.
• Improved joint function and mobility.
• Potential definitive diagnosis if a biopsy is performed.
• Quick improvement in symptoms is expected within a few weeks.

Recovery

• Patients may need to wear a splint or brace for a few weeks.
• Instructions on wound care and signs of infection.
• Physical therapy to restore range of motion and strength.
• Full recovery and return to normal activities can take 4 to 6 weeks.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Conservative treatments such as physical therapy, medication, and injections.
• Arthroscopic surgery, which is less invasive and may result in quicker recovery.
• Pros and cons: Arthroscopy has a faster recovery but may not be suitable for all cases; conservative treatments are non-invasive but may not provide relief.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-operatively, there may be discomfort and mild pain managed with prescribed pain relievers. Swelling and bruising around the elbow are common, and physical therapy will help in regaining motion and function.