(03) 8415 1907
(03) 8415 1907
(03) 8415 1907
(03) 8415 1907
(03) 8415 1907

ELBOW SURGERY

Elbow Arthroscopy (Keyhole Elbow Surgery)

Arthroscopic elbow surgery: minimally invasive treatment for elbow conditions

Elbow arthroscopy, commonly referred to as keyhole elbow surgery, is a minimally invasive surgical technique used to diagnose and treat a range of elbow conditions. The procedure uses a small camera (arthroscope) and specialised surgical instruments inserted through tiny incisions around the elbow joint. This technique allows detailed visualisation of the joint while minimising disruption to surrounding tissues. In appropriately selected patients, elbow arthroscopy may assist with pain relief, improve movement, and address mechanical symptoms such as catching or locking of the joint.
On this page, you will learn how elbow conditions are assessed prior to arthroscopic surgery, when keyhole elbow surgery may be recommended, the types of procedures that can be performed using arthroscopy, expected recovery and rehabilitation timelines, and guidance on safely returning to work, sport, and everyday activities following surgery.

1. What is elbow arthroscopy?

Elbow arthroscopy involves inserting a thin fibre-optic camera into the elbow joint through small incisions. The camera transmits high-definition images to a monitor, allowing precise assessment of cartilage, ligaments, tendons, and joint surfaces. Specialised instruments can then be introduced through additional small incisions to perform treatment within the joint.

Compared with traditional open surgery, arthroscopy typically involves:

Smaller
incisions

Less soft tissue disruption

Improved visualisation of joint structures

Potentially faster early recovery in selected cases

Not all elbow conditions are suitable for arthroscopic surgery. Careful assessment is required to determine whether it is the most appropriate treatment option.

2. Conditions that may be treated with elbow arthroscopy

Elbow arthroscopy may be used to treat several elbow disorders, particularly those involving joint surfaces or internal mechanical problems including:
  • Elbow stiffness and loss of motion - Arthroscopy may be used to remove scar tissue, release contracted joint lining (capsular release) or remove bone spurs that restrict movement. This can assist with restoring range of motion in selected patients.
  • Loose bodies in the elbow joint - Loose fragments of cartilage or bone may develop following injury or arthritis. These fragments can cause locking or catching sensations, pain during movement, or a sudden loss of elbow motion. Arthroscopic removal of loose bodies can help improve joint function and reduce these mechanical symptoms.
  • Elbow arthritis (early or moderate) - In carefully selected cases, arthroscopy may be used to perform a joint “clean-up” procedure. This may include removal of inflamed tissue, smoothing cartilage surfaces, and removing bone spurs. The arthroscopy is often combined with a 3cm incision behind the elbow to allow more aggressive removal of bone build-up blocking movement. While arthroscopy does not reverse arthritis, it may assist with symptom pain relief and better range of motion in selected patients. Improvement in movement range lasts for up to 10 years, and the procedure can be repeated. This process may delay or prevent more major surgery.
  • Tennis elbow (lateral epicondylitis) - For patients with persistent symptoms despite appropriate non-operative treatment, arthroscopic techniques may be used to release or treat diseased tendon tissue.
  • Elbow instability or ligament injury - In some cases, arthroscopy can assist in assessing ligament injury or treating associated joint damage. Certain ligament reconstructions may be performed using arthroscopic or combined techniques.
  • Osteochondral Lesions - Damage to cartilage and underlying bone, particularly in younger athletes or overhead sports participants, may be treated arthroscopically in selected cases. The condition responsible for this is called Osteochondritis Dissecans (OCD). These lesions may be pinned in place to help healing or removed completely if they are small with no significant long-term consequences.

3. Symptoms that may indicate the need for elbow arthroscopy

Patients who may benefit from specialist assessment for arthroscopic elbow surgery often experience:
  • Persistent elbow pain
  • Mechanical symptoms such as locking or catching
  • Stiffness or restricted movement
  • Swelling within the joint
  • Symptoms that do not improve with physiotherapy or other non-surgical treatments

4. How suitability for elbow arthroscopy is assessed

Assessment involves a detailed evaluation of symptoms, examination findings, and imaging results.

This typically includes:

  • Detailed clinical history and physical examination
  • X-rays to assess bone alignment and joint changes
  • MRI or CT scanning where required to assess cartilage, ligaments, or loose bodies

The goal is to identify the underlying cause of symptoms and determine whether minimally invasive surgery is likely to provide benefit.

5. How elbow arthroscopy is performed

Elbow arthroscopy is typically performed under general anaesthesia as a day case.

During the procedure:

  • A tourniquet is used to reduce blood flow during the surgery
  • Small incisions (portals) are created around the elbow
  • The arthroscope is inserted to visualise the joint
  • Specialised instruments are used to treat the identified condition
  • The joint is carefully assessed to ensure all contributing factors are addressed
  • Wounds are closed with absorbable suture, and a waterproof dressing is applied with a compression bandage over that.
  • The bandage may be removed to allow daily showering.
  • The waterproof dressing will be removed at the time of review in the office 10 to 14 days after the surgery.
Procedure time varies depending on the condition being treated, from 20 to 90 minutes.

6. Recovery after elbow arthroscopy

Recovery varies depending on the underlying condition and procedures performed.

Rehabilitation generally includes:

  • Early movement - Gentle elbow movement is encouraged in all cases other than repair of OCD lesions immediately after surgery to reduce stiffness.
  • Physiotherapy rehabilitation - A structured physiotherapy program ensures restoration of maximum movement, strength, and return to best function.
  • Gradual return to activity - Return to work and sport is guided by healing progress, surgical findings, and individual demands. Many patients return to light physical activities within 2 weeks, with driving, office work and most simple tasks performed within a few days of the surgery.
  • Regular anti-inflammatory medication for 2 to 3 weeks (if tolerated) helps minimise pain and swelling to allow fastest recovery.
Elbow Arthroscopy Rehabilitation Guidelines

7. Potential benefits of arthroscopic (keyhole) elbow surgery

In appropriate cases, arthroscopy may offer*:
  • Smaller surgical incisions
  • Reduced soft tissue disruption
  • Detailed visualisation of the joint
  • Treatment of multiple joint problems during one procedure
  • Earlier mobilisation in selected patients
*Individual outcomes vary depending on the condition being treated and overall joint health.

8. When open elbow surgery may be required

Although arthroscopy is effective for many elbow conditions, some injuries or structural abnormalities require open surgical techniques.
These may include:
  • Complex fractures
  • Advanced arthritis
  • Most ligament reconstructions
  • Large bone deformities

Dr Richard Dallalana will discuss whether arthroscopic or open surgery is most appropriate based on your diagnosis and treatment goals.

9. Choosing the most appropriate elbow surgery for your condition

Elbow arthroscopy is highly technique-dependent and requires detailed understanding of elbow anatomy and surrounding nerves. Dr Richard Dallalana provides specialist assessment of elbow conditions and utilises arthroscopic techniques wherever appropriate. Treatment recommendations are tailored to the specific diagnosis, severity of symptoms, and functional requirements of each patient.

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