Tennis Elbow Surgery

What is tennis elbow?

Tennis elbow, or lateral epicondylitis, occurs due to overuse or repetitive strain on the tendons attached to the outer elbow. This leads to inflammation, pain, and tenderness. It is common among individuals who frequently perform repetitive forearm movements, such as tennis, gardening, typing, painting, and playing musical instruments. Trauma can also contribute to the condition. While tennis elbow can cause significant pain and affect daily activities, it is a treatable condition.

Common symptoms include pain on the outer side of the elbow, which may extend to the forearm and wrist. Additionally, patients may experience a weak grip and discomfort when bending the wrist backward. Without treatment, symptoms may worsen and interfere with everyday activities. A consultant can diagnose tennis elbow through a medical history review and physical examination. In some cases, X-rays or MRI scans may be required to rule out other conditions or assess the extent of tendon damage.

What is lateral epicondyle release surgery?

Lateral epicondyle release surgery is a procedure used to treat tennis elbow (lateral epicondylitis) when more conservative treatments have failed. This surgery aims to take tension off the extensor tendon to relieve pain.

When lateral epicondyle surgery release recommended?

If conservative treatments—such as rest, ice, anti-inflammatory medication, physiotherapy, splinting, and steroid injections—fail to relieve symptoms after 6 to 12 months, tennis elbow surgery also known as lateral epicondyle release surgery, may be considered. This procedure is generally recommended as a last resort for about 10% of patients.

What does the procedure involve?

When patients arrive at the hospital, they will meet a nurse, the anaesthetist and their surgeon. Lateral epicondyle release is performed under general or regional anaesthesia, usually as a day case.

The surgery involves removing the damaged portion of the tendon and reattaching the healthy tissue to the bone. This process promotes healing and reduces pain.

Types of surgery

• Open surgery: The surgeon makes a small incision near the elbow to access and remove the damaged tissue.
• Endoscopic (keyhole) surgery: This minimally invasive procedure uses small incisions and a camera to guide the surgeon. When possible this approach may result in a quicker recovery and less visible scarring than open surgery.

What are the potential risks and complications?

As with any surgery, there are potential risks, including:

• Infection at the surgical site
• Nerve damage, which may cause numbness or weakness in the forearm or hand
• Continued pain or failure to relieve symptoms, requiring further treatment
• Recurrence of symptoms

The surgeon will thoroughly discuss these risks with the patient before the procedure to ensure they are fully informed.

After the procedure

Recovery times vary, but most patients can resume light activities within a few weeks. The surgeon will provide a personalised physiotherapy plan to help restore strength and flexibility in the elbow. Tennis elbow surgery generally has a high success rate.

Most patients experience significant pain relief and improved elbow function. The majority experience a full recovery and can return to their normal activities, including sports, within 3 to 6 months after surgery, depending on the extent of the procedure and their overall health.