To provide stability and strength to the elbow joint, the ulnar collateral ligament, radial collateral ligament, and annular ligament provide support. Additionally, the common flexor and extensor tendons are attached to the joint, with associated muscle groups that facilitate the rotational movement of the forearm, as well as the movements of the wrist and hand.
Injuries to the elbow joint and surrounding tendons are commonly caused by repetitive stress from activities such as sports, weight lifting, and mechanical work, which may lead to overuse injuries like tennis elbow and golfer's elbow. Meanwhile, ligament injuries may result from sprains, ruptures, or trauma due to direct injury or repetitive stress.
Symptoms of elbow joint and surrounding structure injuries typically include pain and swelling in the affected area that may extend from the elbow to the forearm and palm, and may be aggravated by wrist movements. Joint instability may also be observed in some cases.
The repair of the damaged tendon is broadly classified into two types- tendon debridement and tendon release.
Tendon debridement is a surgical procedure commonly used to manage tendinitis. In this procedure, damaged tissue is removed from the tendon and the tendon is cleaned.
Tendon release is a commonly used surgery for tendon repair. During this procedure, the surgeon locates the attachment of the extensor or flexor tendon on the elbow, splits the damaged tendon, removes any scar tissue or overgrowth around the tendon, and may suture the loose end of the tendon to surrounding connective tissue (fascia).
Ligament reconstruction is recommended for patients with ligament rupture. During the surgery, the surgeon makes an incision over the elbow, carefully moves muscles, tendons, and nerves out of the way, and harvests a donor tendon from either the forearm or below the knee. The surgeon then drills holes into the bones of the upper arm and forearm around the elbow joint and inserts the donor tendon through the drilled holes in a pattern like that of the original ligament complex. The tendon is attached to the bone surfaces with special sutures. After the surgery, the incision is closed with sutures and covered with sterile dressings, and a splint is applied to support the elbow for a few weeks. Regular follow-up appointments and rehabilitation programs may be advised for a better and quicker recovery.
Common complications of the elbow ligament and tendon repair surgeries include infection, injury to the adjacent nerve and blood vessels, and a loss of strength or flexibility of the elbow joint.
The success of the surgery depends on the post-operative rehabilitation program which includes the use of a removable splint immediately after surgery as well as ice therapy, electrical stimulation and massage for reducing pain, swelling or muscle spasm. Isometric exercises, strengthening and range of motion exercises may be useful for long term rehabilitation.