Removal of Loose Bodies or Spurs
Other popular names
Who does it affect?
Why does it happen?
The elbow joint is a hinged joint where the upper arm bone (humerus) meets the two forearm bones (ulna and radius). The main stabilizing structure of the elbow joint is the ligament along the inner aspect of the elbow (medial collateral ligament.). The unique anatomy of the elbow joint allows it to pass through a broad range of motion. During repetitive overhead and lifting sports and occupations, the elbow experiences tremendous stress. This may lead to the formation of small loose fragments of cartilage or bone (loose bodies) or elbow joint spurs.
The loose bodies can cause pain, clicking or locking of your elbow. Your elbow may get 'stuck' and then click free (unlock). This is often painful. Sometimes you may feel something moving around inside your elbow joint and be aware of the loose body
This condition will be identified using plain x-ray. Sometimes a CT scan may be needed.
Treatment consists of avoiding repeated trauma or pressure to the elbow area and resting the elbow joint. Occasionally, ice can help will be offered surgery at this point. As there is really a ‘loose body’ in the joint, any non-surgical treatment is likely to provide only short term or sporadic relief. In the majority of cases I will offer to remove the offending body through arthroscopic surgery.
Surgery is carried out as a day case procedure usually under general anaesthetic and takes about 15-30 minutes.
An elbow arthroscopy introduces an arthroscope (small 'telescope') into the elbow joint through several small 4 mm incisions. The arthroscope is used to identify the location of the loose bodies and the spurs. The loose bodies can be removed by using the arthroscope in addition to small grasping instruments. The bone spurs can be removed by visualizing the spur with the arthroscope and using a small burr to remove the spur. The skin is sutured or fixed using steristrips and a bulky dressing is applied.
You can go home soon after the operation. Simple analgesia (pain killers) usually controls the pain and should be started before the anaesthetic has worn off. The arm should be elevated as much as possible for the first 5 days to prevent the hand and fingers swelling. Gently bend and straighten the fingers and elbow from day 1. The dressing will be removed soon after your operation. The wound is cleaned and redressed with a simple dressing. Avoid forced gripping or lifting heavy objects for 2-3 weeks. The sutures are removed at about 12 days. You should notice an improvement in symptoms within a few weeks but the final result may take some 3-6 months.
Return to normal routine
Keep the wound dry until the stitches are out at 12 days.
Return to driving:
The hand needs to have full control of the steering wheel and left hand the gear stick. You are advised to avoid driving for at least 7 days or until the sutures (stitches) are removed.
Return to work:
Everyone has different work environments. You will be given advice on your own particular situation.
Overall over 95% are happy with the result. However complications can occur.
General risks (less than 1% each):
- Neuroma (nerve pain)
Reflex Sympathetic Dystrophy - RSD (<1% people suffer a reaction to surgery with painful stiff hands, which can occur with any elbow surgery from a minor procedure to a complex reconstruction).
- Nerve damage
- Blood vessel damage