Arthroscopic removal of loose bodies

The formation of loose bodies in the elbow is usually a sign of degenerative change and osteoarthritis. Their presence can be merely an incidental finding when the elbow is being investigated for pain and stiffness, but they may also cause specific symptoms of locking and episodes of sudden severe pain. If so they can be removed with the size of the loose body will usually dictating the technique needed to remove them. Arthroscopic (key hole) or open techniques may both be used to remove them.

The arthroscopic removal of loose bodies usually involves two or three small (1cm) incision around the elbow. This allows access to the joint so that the loose bodies can be removed. If necessary, a release of any associated capsule contracture can also be undertaken at the same time. Alternatively, and especially if the loose bodies are too large to be removed arthroscopically, an open operation may be necessary. This is most likely to be in the form of an Outerbridge – Kashiwagi (OK) procedure.

Information for patients / operative Information

Risks and complications

• Infection
• Bleeding
• Nerve injury
• Continued discomfort
• Residual or recurrentloose body formation
• Continued stiffness

Before admission

• Please bring any X-rays or scans with you to the hospital. This will usually be on a CD disc. These will not be needed if it was Mr. Falworth who organised the investigations.
• No food for 6 hours, or drink for 4 hours, prior to surgery.
• Please avoid smoking for 12 hours prior to surgery

In Hospital

• An arthroscopic removal of loose bodies is usually undertaken as a day case of single overnight stay procedure.
• Two or three incisions, each measuring approximately 1cm in length are made on either side of the elbow.
• The wounds are repaired with dissolving buried sutures and Steri-strips
• Splash proof dressings will be applied but the wound should remain dry for 10 days.
• Prior to your discharge from hospital, a physiotherapist will demonstrate some simple exercises as part of your rehabilitation protocol. These exercises should be undertaken when you’re at home and will help your shoulder recover from the surgery before your outpatient physiotherapy commences.

What to Expect

• Swelling; immediately after an elbow operation there can be quite a lot of swelling around the elbow and hand. This settles after approximately 24 hours but can be speeded up if gentle finger movements are undertaken soon after the operation.. The use of ice or alternative cold therapy compress, can be helpful in minimising swelling and inflammation.
• Pain; an Interscalene Block is often used to reduce immediate post-operative pain. If any discomfort arises once the block has worn off, simple oral analgesics can be taken to manage this. These will be provided to you upon discharge.
• Bleeding; there may be some oozing through the bandages but this should settle soon after the operation.

Post-operative care

• A sling will be provided to help rest the elbow during the day. This should be discarded as soon as possible, (usually between 3-7 days) so as not to encourage any t stiffness.
• The wound should be kept dry for 10 days.
• At ten days the dressing and paper Steristrips can be gently removed. If the wound is ‘dry’ then it is all right to wash the wound, if not consult Mr. Falworth.
• The most important part of your post-operative care is to start an early exercise programme, which the ward physiotherapist will have commenced prior to discharge from hospital. This will maximise the benefit of your operation and will continue as an out-patient.

Post-operative appointments

• You will be reviewed in clinic approximately 3 weeks following your surgery.

Estimated return to Functional activities