Name of the Procedure:

Arthroscopy, elbow, surgical; synovectomy, complete

Summary

This procedure involves using a small camera called an arthroscope inserted into the elbow joint to visualize, diagnose, and surgically remove the synovium, a tissue lining the joint. It is minimally invasive, meaning smaller incisions and quicker recovery compared to traditional surgery.

Purpose

The primary purpose of this procedure is to address conditions causing inflammation and damage to the synovium, such as rheumatoid arthritis or other inflammatory joint diseases. The expected outcome is to reduce pain, improve joint function, and prevent further joint damage.

Indications

• Chronic elbow pain not relieved by non-surgical treatments
• Persistent joint swelling and inflammation
• Limited elbow movement
• Diagnosed rheumatoid arthritis or synovial joint disorders
• Synovial hypertrophy or thickening visible on imaging tests

Preparation

• Fasting for at least 8 hours before the procedure
• Stopping certain medications, such as blood thinners, as advised by the physician
• Undergoing pre-operative assessments, including blood tests and imaging studies like X-rays or MRI

Procedure Description

1. The patient is positioned and anesthesia is administered. General or regional anesthesia may be used.
2. Small incisions (portals) are made around the elbow.
3. An arthroscope is inserted through one of the portals to visualize the joint interior on a monitor.
4. Surgical instruments are inserted through other portals to remove the synovium completely.
5. The joint is irrigated and checked for any remaining synovium or debris.
6. Incisions are closed with sutures, and a sterile bandage is applied.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Usually performed in a hospital operating room or an outpatient surgical center.

Personnel

• Orthopedic surgeon specialized in arthroscopic procedures
• Anesthesiologist or nurse anesthetist
• Operating room nurses and technicians

Risks and Complications

• Infection at incision sites or within the joint
• Excessive bleeding or blood clots
• Nerve damage leading to numbness or weakness
• Joint stiffness or limited range of motion
• Risks related to anesthesia

Benefits

• Reduction in pain and swelling
• Improved joint function and range of motion
• Decreased progression of joint damage
• Shorter recovery time compared to open surgery

Recovery

• Patients may go home the same day or following a short hospital stay
• Pain management with prescribed medications
• Physical therapy to regain strength and mobility
• Avoiding strenuous activities and follow-up appointments for suture removal and joint evaluation
• Full recovery may take several weeks to months

Alternatives

• Non-surgical treatments like medications, physical therapy, or corticosteroid injections
• Open elbow surgery for severe cases
• Each alternative comes with different risks, recovery times, and effectiveness levels

Patient Experience

• During the procedure, patients are under anesthesia and won't feel pain
• Post-procedure, mild to moderate pain is common and managed with medication
• Swelling and discomfort may occur for a few days
• Gradual return to daily activities with specific instructions from the healthcare team