I saw a video at my surgeon’s office on the arthroscopic procedure she plans to do on my elbow. I have a bit of loose cartilage in there that keeps getting caught so she is going to remove it. In the video, the patient was completely covered in surgical linens so that all that was visible was the forearm from the elbow down. This is probably a silly question, but is that really necessary?

You are referring to a technique we call “surgical draping”. The patient is indeed covered from head to toe leaving only the surgical field visible. This approach has been developed over the years to help prevent infection to the patient. It also helps protect the surgical team from any contact with the patient.

The procedure of covering a patient and surrounding areas with a sterile barrier is actually carefully orchestrated. Surgical staff must do it perfectly each time to create and maintain a sterile field during the surgical procedure.

Draping materials may be made of paper or plastic (disposable) or linens (nondisposable). These materials are sterile and again, are designed specifically to maintain a sterile field and prevent the passage of any microorganisms (especially bacteria) from the nonsterile area to the patient.

Elbow arthroscopy is usually done with the patient under general anesthesia. The patient will be relaxed and comfortable. If there is concern for postoperative nausea from the anesthesia, then a regional anesthesia (just the arm is numbed) can be used. Using a nerve block like this has one major disadvantage. The surgical staff cannot assess the patient’s neurologic status for quite some time after surgery (until the nerve block wears off).

Careful patient positioning is as important as draping. The right patient position gives the surgeon the best view inside and around the joint. Depending on the procedure, you may be supine (on your back) with the arm suspended by traction or prone (face down) with the arm hanging off the table in a special arm holder. All of these tools and materials must also be sterilized to help maintain a sterile environment and prevent infection.