Much like arthroscopic shoulder surgery, arthroscopic elbow surgery is performed through small incisions in which the camera and instruments are inserted, making it a less invasive procedure. This allows for less pain for the patient, a quicker recovery time, and less stiffness in the joint. Arthroscopic elbow surgery is done as an outpatient procedure. Recovery time after arthroscopic surgery varies based on the patient and procedure being performed. The goal is to have the patient returning to sport activities in 2-3 months.
When the elbow is bent, the ulnar nerve stretches around the bony bump at the end of the humerus. In throwing athletes, the ulnar nerve is stretched repeatedly, and can even slip out of place, causing painful snapping. This stretching or snapping leads to irritation of the nerve, a condition called ulnar neuritis. Athletes with ulnar neuritis will notice pain that resembles electric shocks starting at the inner elbow and running along the nerve as it passes into the forearm. Numbness, tingling, or pain in the small and ring fingers may occur during or immediately after throwing, and may also persist during periods of rest.
Ulnar neuritis is not restricted to just athletes. It can also occur in non-athletes who frequently notice these same symptoms when first waking up in the morning, or when holding the elbow in a bent position for prolonged periods of time.
If nonsurgical treatments are ineffective, ulnar nerve transposition surgery may be the best option for the patient. In this procedure, the nerve is moved to the front of the elbow to prevent stretching or snapping.
One of the most common injuries to athletes who repetitively throw overhand is in the ulnar collateral ligament or UCL. Pain is often focused on the inside of the elbow both during and after throwing, and athletes will notice a decrease in throwing velocity. Injuries to the UCL can range from minor inflammation to a complete tear to the ligament. Dr. Joyce will confirm the extent of injuries to the UCL with an MRI.
If surgery is deemed the best course of treatment for the patient, Dr. Joyce will perform what is more commonly known as Tommy John Surgery. Recovery time after UCL reconstruction surgery can vary depending on the patient. It generally takes about six months before the patient can return to competitive throwing, assuming compliant post-operative care and physical therapy.