Arthroscopy of the elbow, the inspection of the joint from within, is a minimally invasive technique: through small access points I look into the joint with a camera and treat the findings in the same procedure. It helps with a tennis elbow just as it does with loose bodies, stiffness or instability. Whether it makes sense in an individual case depends on the findings.
In short
In an elbow arthroscopy I bring a camera and fine instruments into the joint through small skin incisions. I assess cartilage, capsule, ligaments and joint lining under direct view and treat the findings in the same session: removing loose bodies, releasing scarring, taking down bone spurs, smoothing cartilage, removing thickened folds of the joint lining or testing stability. Because the access points are small, the joint can usually be moved early — and at the elbow in particular, that counts. Not every finding can be dealt with arthroscopically.
The elbow is no simple hinge: the humerus, the ulna and the radius form three partial joints within a shared capsule. That tight space makes it sensitive — even a thickened fold of the joint lining can catch.
For the arthroscopy I fill the joint with sterile fluid so that the space between the bones opens up. The optic comes in through a small skin incision, the instruments through further access points. On the monitor I work through cartilage, capsule, ligament insertions and joint lining one after the other — whatever it reveals I usually treat at the same time.
Particular care is called for by the closeness of the nerves, above all the ulnar nerve and the radial nerve; the access points are therefore marked out before the incision. How the technique is used at the shoulder and the wrist is set out on the page on arthroscopy in overview.
Areas of application
Six sets of symptoms at the elbow can be approached arthroscopically.
In epicondylitis lateralis (tennis elbow) the tendon insertion on the outside is irritated, in golfer's elbow the one on the inside. If the complaints persist despite conservative treatment, I treat the tendon insertion arthroscopically and deal with accompanying damage at the same time.
Treating tennis and golfer's elbowDetached fragments of cartilage or bone travel around inside the joint and cause sudden catching and blockage. Such loose bodies can be located and removed arthroscopically, without opening the joint.
Making sense of elbow painCartilage can break in a fall or wear down over the years. In osteoarthritis of the elbow I smooth roughened surfaces, remove unstable cartilage edges and take down bone spurs that get in the way. The wear itself is not undone by that.
Elbow osteoarthritis in overviewAfter fractures, dislocations or a longer immobilisation the joint capsule shrinks and scars over. In arthroscopic arthrolysis (release of the scarring) I split the thickened capsule and take down the bone spurs that block movement. Physiotherapy then follows.
Arthrolysis for the stiff elbowAfter a dislocation, or through repeated overload, the outer ligament complex (LUCL) can lose its guiding hold. Arthroscopy allows the instability to be confirmed directly: under direct view I test whether the joint opens up. Ligament reconstruction then follows.
Elbow instability and ligament reconstructionA thickened fold of the joint lining catches on the outside between the radial head and the humerus and can be taken away under direct view.
Treating the snapping foldAt the beginning come the conversation and the clinical examination; ultrasound is available to me in the practice, and where needed I arrange an X-ray or MRI. I plan a procedure when complaints and findings fit together. For irritative conditions such as tennis elbow, conservative routes come first: ultrasound-guided injection, shockwave therapy, PRP therapy and physiotherapy. If loose bodies block the joint or the elbow is unstable, arthroscopy may also be indicated early, depending on the findings.
Before the date of the procedure I go through what is planned arthroscopically and what may additionally become necessary. General or regional anaesthesia is explained separately by the anaesthetist. I carry out necessary procedures at the ATOMOS Klinik Währing, the Privatklinik Döbling or the Rudolfinerhaus, and I accompany you from planning through the procedure to aftercare.
After that, movement counts. The elbow tends towards stiffness, which is why guided mobilisation begins as early as the findings allow — earlier after an arthrolysis, more protected after a ligament repair. Physiotherapy and exercise therapy are available in the building at the Orthozentrum Döbling. For operations, direct settlement with a supplementary private insurance is possible; more on that under private practice and billing.
Arthroscopy does not replace the open operation where the findings call for it: large ligament reconstructions, displaced fractures, transposition of the ulnar nerve or a joint replacement need direct access. Where the bone is markedly altered or the scarring pronounced, the room inside the joint can also be too tight.
Every procedure carries risks; at the elbow the closeness of the nerves stands in the foreground, and swelling, infection or renewed scarring are possible as well. A worn joint moreover stays worn, and a stiff elbow needs consistent exercise afterwards — I say that openly beforehand. Whether an elbow arthroscopy makes sense we decide together on the basis of the findings; the alternatives are an open operation or the conservative treatments.
Frequently asked
An inspection of the elbow joint from within: through small skin incisions I bring a camera and fine instruments into the joint, assess cartilage, capsule, ligaments and joint lining on the monitor and treat what I find in the same session. The technical term is arthroscopy; in everyday language people speak of keyhole surgery.
Above all for a tennis or golfer's elbow that does not respond to conservative treatment, for loose bodies that catch, for cartilage damage and osteoarthritis, for restricted extension or flexion, for suspected instability and for a fold of the joint lining that catches. The precondition is that complaints, examination and imaging fit together.
The elbow offers little room, and important nerves run close to the joint. That is why it is filled with fluid before the procedure, and why the access points are marked out before the incision and made in a standardised way. Experience with precisely this joint counts here; I specialise in elbow arthroscopy.
With movement, as early as the findings allow. The elbow tends towards stiffness, which is why guided mobilisation is part of the treatment and not only of late aftercare. Physiotherapy and exercise therapy are available in the building at the Orthozentrum Döbling, and I carry out the check-ups myself in the practice.
I carry out necessary procedures at the ATOMOS Klinik Währing, the Privatklinik Döbling or the Rudolfinerhaus, and I accompany you from planning through the procedure to aftercare. Which location is an option depends on the planned procedure and on your insurance; we clarify that together beforehand.
My practice is a private practice, in Austria a Wahlarztordination. I do not settle directly with any public health insurer; you receive an invoice and submit it to your insurer — on request I take care of the submission for you. For operations, direct settlement with a supplementary private insurance is possible.
Then I discuss the open operation, for instance for a ligament reconstruction, for displaced fractures or for the release of the ulnar nerve. Sometimes waiting is also sensible, if conservative treatment still has scope. The findings determine the way, not the technique.
Dr. med. Martin Eigenschink
Specialist in Orthopaedics and Traumatology · Specialist in elbow, shoulder and hand surgery
Surgical and conservative treatment of the elbow, shoulder and hand, preferably minimally invasive. Practice at the Orthozentrum Döbling, 1190 Vienna. More about my background
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Medical notice: The contents of this page serve as general information. They do not replace a medical examination, diagnosis or individual advice. Medicine is a constantly evolving field — despite careful research, no guarantee can be given that the content is fully up to date.