Elbow

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Elbow Instability

Elbow instability is usually described differently by many patients. It can range from a complete dislocation of the joint that physically must be relocated, or a feeling of slippage or shifting that may occur during normal or athletic activities.

Elbow instability may be caused by tearing or loosening of the ligaments that bind the elbow bones together. Symptoms may range from pain with activity to sensations such as "catching, popping or clicking", or locking of the elbow. These symptoms usually accompany a traumatic event and is more commonly identified with laxity of the lateral or outer elbow ligaments. The most common position when this occurs is with a straight elbow and the palm faces upwards. In the absence of past or recent trauma, a related soft tissue disorder creating abnormal looseness of the tissue may be present.

Instability of the elbow joint requires elbow ligament reconstruction via arthroscopic surgery to restore the normal movement and function to the joint. Typically, suspected elbow instability is usually demonstrated at the time of surgery, when the patient is asleep and the surrounding muscles no longer guard or support the joint.

Surgical Goals

When elbow instability has been confirmed, the aim of the elbow ligament reconstruction via arthroscopic surgery is to restore stability. This will involve either reattaching the torn ligamentous tissues or reconstructing the ligament using other tissues within the arm to substitute.

Elbow Ligament Reconstruction via Endoscopic Surgery

In the absence of good ligamentous tissue to reattach, the elbow surgeon may utilize a forearm/wrist tendon that has essentially no function and would not be noticed if it were harvested to be used as the graft. If this tendon is not accessible (approx 10 % of the population do not have this muscle) then your elbow surgeon may chose another area of the body (knee/thigh hamstring graft) to use as the graft tissue.

Once the tendon is chosen and harvested it is prepared and fashioned in a way to replace the route and function of the injured ligament. At that time the graft is secured, stability and mobility are ensured and the wound closed.

After the elbow ligament reconstruction via endoscopic surgery is complete, the arm and elbow are wrapped and splinted in protective fashion. Gradually, over the next 6 weeks, range of motion is allowed to increase using a protective progressive hinged brace.

The aim of the elbow ligament reconstruction via endoscopic surgery is to provide functional mobility and stability to the elbow. Long term results are usually very good but on occasion some patients will still have some ongoing pain, stiffness and slight instability.

For more information on how the endoscopic surgery specialists at Cary Orthopaedics can help you, contact us today at 919-467-4992 for an appointment!

Cary Orthopaedics serves patients from Raleigh, Garner, Cary, Apex, Holly Springs, Fuquay-Varina, Clayton, Chapel Hill, and Pittsboro, NC