Elbow arthroscopy: surgical techniques and rehabilitation.
Elbow arthroscopy allows for direct visualization into the elbow joint, minimizes the potential for postoperative edema and discomfort, as well as protects the ligamentous structures. Arthroscopic procedures for the elbow and postoperative management are described for patients who have undergone loose body removal, synovectomy, and capsulectomy. The effect of early mobilization on the elbow complex and the role that splinting may play, as well as the controversies surrounding the use of continuous passive motion are discussed. Arthroscopy can significantly reduce the time frame, as well as improve the functional outcome, of a postoperative rehabilitative program. There is evidence to support the reduced need for postoperative therapy, as well as quicker return to premorbid activity. However, the evidence to suggest that there is significant difference between open vs. arthroscopic repairs with regard to functional outcome is inconsequential. Complications after an arthroscopic release can arise, such as prolonged edema, which may lead to protracted joint stiffness or delayed healing. Iatrogenic nerve injury is also a potential risk that may pose devastating consequences for the individual's functional outcome. In light of all these facts, it is imperative that arthroscopic procedures be performed by experienced surgeons, who can then refer the patient to a skilled hand therapist who will work in conjunction with and communicate to the physician if complications arise.
Brach
Paul
P
Hand and Upper Extremity Rehabilitation Program, Centers for Rehab Services, Pittsburgh, Pennsylvania 15213, USA. brachpj@upmc.edu
Goitz
Robert J
RJ
D000328:Adult; D020679:Arthroscopes; D001182:Arthroscopy / Q000379:methods*; D004551:Elbow Joint; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000534:rehabilitation* / Q000601:surgery*; D008297:Male