Elbow surgery is performed by the NefroCenter Group’s Center for Complex Orthopedic Surgery with personalized pathways and an experienced team of professionals of high international standing.
Elbow surgery is performed by the Center for Complex Orthopedic Surgery of the NefroCenter Group. It is necessary for conditions that can significantly limit daily life: persistent pain, stiffness, loss of strength, instability, outcomes of fractures, nerve compression or joint degeneration. The elbow is a less “visible” joint than the shoulder or the knee, but it is essential for simple gestures such as bringing the hand to the mouth, dressing, washing, writing, working or playing sports.
The pathway leading to elbow surgery starts with identifying the cause of the problem, assessing whether conservative treatment is possible and, when necessary, planning a targeted operation.
Elbow surgery requires specific expertise, because the joint is complex, close to delicate nerve structures and particularly prone to stiffness after trauma or surgery. This is why the pathway must be personalized and followed by an experienced team.
The elbow is a complex joint formed by three bones: the humerus, the radius and the ulna. In fact, three joints coexist within it: the humeroulnar, the humeroradial and the proximal radioulnar joint.
This structure allows two fundamental movements. The first is flexion-extension, that is, bending and straightening the arm. The second is pronation-supination, which makes it possible to rotate the forearm and turn the palm of the hand upward or downward.
The stability of the elbow depends on the medial and lateral collateral ligaments, on the congruence of the joint surfaces and on the balance of the muscles acting on the forearm. An important role is also played by the ulnar nerve, which passes through the cubital tunnel region and is particularly exposed to compression.
When one of these structures is altered, pain, tingling, loss of strength, joint locking or difficulty in movement can appear. Even a small limitation of the elbow can have a strong impact on quality of life, because it prevents essential gestures and reduces independence.
Lateral epicondylitis, also known as tennis elbow, and medial epicondylitis, called golfer’s elbow, are tendinopathies affecting respectively the lateral and the medial side of the elbow. They cause pain when gripping, lifting or twisting. In most cases they are treated with physical therapy, physical modalities, injections and changes in activity. Surgery is considered when the pain persists despite an adequate conservative pathway.
Elbow instability occurs when the joint loses its normal stability. It can be lateral, medial or complex, often after trauma, dislocations or ligament injuries. The patient may feel giving way, pain, a sense of insecurity and difficulty in movements under load. In the most severe cases ligament reconstruction may be necessary.
Elbow dislocation is the loss of the normal joint relationships. It can be simple, when not associated with fractures, or complex. One of the most delicate forms is the so-called “terrible triad”, which includes dislocation, fracture of the radial head and fracture of the coronoid. In these cases treatment must restore joint stability and movement.
Fractures can involve the distal humerus, the radial head, the olecranon or the coronoid. They can result from falls, sports accidents or high-energy trauma. The choice between conservative and surgical treatment depends on the type of fracture, the displacement of the fragments and the stability of the joint. The goal is to promote correct healing and prevent stiffness.
Elbow osteoarthritis is less frequent than in other joints, but it can cause pain, stiffness and reduced movement. It can appear after trauma, work-related overload, intense sports activity or rheumatic diseases. In early cases conservative treatments can be used; in advanced forms surgery or, in selected cases, elbow replacement may be indicated.
Cubital tunnel syndrome is caused by compression of the ulnar nerve at the elbow. It can cause tingling in the fourth and fifth fingers, pain, loss of sensation and reduced strength in the hand. When symptoms persist or worsen, surgical decompression of the nerve may be indicated, sometimes combined with anterior transposition.
Tendinopathy or rupture of the distal biceps tendon can compromise strength in flexion and supination of the forearm. It is a condition more frequent in active adults and may require surgical treatment, especially in cases of complete rupture or significant loss of function.
After fractures, dislocations or surgery, the elbow can develop stiffness. It is one of the most frequent complications of this joint. Early, well-guided rehabilitation is essential. In the most severe cases, when movement remains very limited, an arthrolysis operation may be necessary to free the joint.
Elbow surgery at the Center for Complex Orthopedic Surgery includes different procedures, chosen according to the condition, the severity of the clinical picture, the patient’s age and activity and the functional goals.
Elbow arthroscopy is a minimally invasive technique indicated in some forms of stiffness, in the removal of loose bodies in the joint, in the treatment of mechanical impingement and in some pictures of early osteoarthritis. It makes it possible to work through small incisions, reducing the impact on the tissues, but requires great experience because of the proximity of nerves and vessels.
Minimally invasive surgery for lateral and medial epicondylitis resistant to conservative treatment aims to treat the degenerated tendon tissue and promote the recovery of function. It is indicated only after an adequate, documented non-surgical pathway.
In elbow instability, ligament reconstructions may be necessary, such as those of the ulnar collateral ligament or the lateral complex. These procedures serve to restore joint stability and control.
Complex fracture-dislocations often require a combined approach: reconstruction of the radial head, fixation of the coronoid and repair of the ligaments. In the most severe trauma, highly specialized solutions may be necessary, up to the mechanical and functional reimplantation of the severely traumatized elbow, a technique documented in the clinical pathways of the NefroCenter Group.
Total or partial elbow replacement is considered in advanced osteoarthritis, in fractures that cannot be reconstructed or in rheumatic outcomes. It is a complex procedure, reserved for selected cases.
Decompression of the ulnar nerve, with possible anterior transposition, is indicated in cubital tunnel syndrome when nerve compression causes persistent symptoms or functional deficits.
The pathway begins with an orthopedic specialist consultation. During the consultation, pain, functional limitation, any previous trauma, work or sports activity and treatments already carried out are assessed. It is useful to bring X-rays, MRI and CT scans, ultrasound scans, electromyography and previous reports.
After the consultation, the specialist may indicate further tests. X-rays make it possible to assess the bones and the joint. CT is useful in complex fractures and in surgical planning. Magnetic resonance imaging makes it possible to study ligaments, tendons and soft tissues. Ultrasound may be indicated for tendons and muscles. Electromyography is important when nerve compression is suspected, as in cubital tunnel syndrome.
The treatment assessment distinguishes between conservative and surgical treatment. Many elbow conditions can improve with physical therapy, physical modalities, injections, braces or changes in activity. Surgery is considered when the pain persists, function is compromised or the injury requires stabilization.
Before the operation the patient undergoes pre-admission, with routine tests and an anesthesia assessment. The simplest operations can be performed as day surgery, while complex procedures, reconstructions or prostheses require ordinary admission.
Surgical times vary. A minimally invasive procedure for epicondylitis can take about 30-45 minutes. A ligament reconstruction can take 1-1.5 hours. An elbow replacement can take 2-3 hours, depending on complexity.
After discharge, check-ups and a rehabilitation protocol are scheduled. In the elbow, rehabilitation is particularly important, because stiffness is a frequent complication. Recovery must be gradual, monitored and adapted to the procedure performed.
Elbow surgery requires coordinated work between several specialists. Orthopedic surgeon, anesthesiologist, physiatrist and physical therapist take part in a shared pathway, from diagnosis to rehabilitation.
Within the NefroCenter Group, Prof. Raffaele Russo is the reference specialist for elbow and shoulder surgery. An orthopedic surgeon with specific experience in the management of instability, complex trauma, joint injuries and advanced reconstructions, he is part of the model of the Center for Complex Orthopedic Surgery of the NefroCenter Group.
The pathway is not limited to the operation. The pre-operative assessment, the choice of technique, pain management, follow-up and rehabilitation are all parts of the same care plan.
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Surgery is considered when pain, instability, stiffness or loss of function do not improve with conservative treatments, or when the injury is too severe to heal properly without surgery. The decision depends on the diagnosis, the tests and the patient’s condition.
The duration varies according to the procedure. Minimally invasive operations can take less than an hour, while ligament reconstructions, complex fractures or prostheses require longer times. The specialist provides an estimate after the clinical assessment.
Arthroscopy is minimally invasive, but some post-operative pain may be present. It is managed with drug therapy and dedicated protocols. Recovery depends on the condition treated and on the individual response.
Recovery can vary from a few weeks to several months. Simple procedures have shorter times, while complex fractures, reconstructions or prostheses require a longer, more structured rehabilitation pathway.
It depends on the type of work. Light or office activities can resume sooner, while manual work, sports or jobs involving loads require longer times. The return is established during post-operative check-ups.
In many cases yes, but the return to sports must be gradual and authorized by the specialist. It depends on the type of operation, the sport practiced and the recovery of strength, stability and mobility.
The lifespan of an elbow prosthesis depends on age, bone quality, type of implant, the patient’s activity and check-ups over time. It is important to follow the specialist’s instructions and respect any functional limitations.
You can contact the NefroCenter Group, indicating the elbow problem and the preferred facility. The secretariat provides information on availability, documents to bring and the most suitable pathway.
Yes. A second opinion is useful when the patient has already received a diagnosis or a surgical proposal and wishes to clarify indications, alternatives and recovery times.
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