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Tennis elbow surgery

Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery

Tennis elbow is caused by doing the same repetitive and forceful arm movements many times. It creates small, painful tears in the tendons in your elbow.

This injury can be caused by tennis, other racquet sports, and activities such as turning a wrench, prolonged typing, or chopping with a knife. The outside (lateral) elbow tendons are most commonly injured. The inside (medial) and backside (posterior) tendons can also be affected, but usually with different activities. The condition can be worsened if the tendons are further injured by trauma to the tendons.

This article discusses surgery to repair tennis elbow.

Description

Surgery to repair tennis elbow is often an outpatient surgery. This means you will not stay in the hospital overnight.

You will be given medicine (sedative) to help you relax and make you sleepy. Numbing medicine (anesthesia) is given in your arm. This blocks pain during your surgery.

You may be awake or asleep with general anesthesia during the surgery.

If you have open surgery, your surgeon will make one cut (incision) over your injured tendon. The unhealthy part of the tendon is scraped away. The surgeon may repair the tendon using something called a suture anchor. Or, it may be stitched to other tendons. When the surgery is over, the cut is closed with stitches.

Sometimes, tennis elbow surgery is done using an arthroscope. This is a thin tube with a tiny camera and light on the end. Before surgery, you will get the same medicines as in open surgery to make you relax and to block pain.

The surgeon makes 1 or 2 small cuts, and inserts the scope. The scope is attached to a video monitor. This helps your surgeon see inside the elbow area. The surgeon scrapes away the unhealthy part of the tendon to promote healing.

Why the Procedure Is Performed

You may need to have surgery if you:

  • Have tried other treatments for at least 3 months
  • Are having pain that limits your activity

Treatments you should try first include:

  • Limiting activity or sports to rest your arm.
  • Changing the sports equipment you are using. This may involve changing the grip size of your racket or the weights that you use.
  • Changing the types of tools that you are using that cause discomfort.
  • Changing your sports practice schedule or duration.
  • Taking medicines, such as aspirin, acetaminophen, ibuprofen, or naproxen.
  • Doing exercises to relieve pain as recommended by your health care provider or physical therapist.
  • Making workplace changes to improve your sitting position and how you use equipment at work.
  • Wearing elbow splints or braces to rest your muscles and tendons.
  • Getting shots of steroid medicine, such as cortisone. This is done by your provider.

Risks

Risks of anesthesia and surgery in general are:

Risks of tennis elbow surgery are:

  • Loss of strength in your forearm
  • Decreased range of motion in your elbow
  • Need for long-term physical therapy
  • Injury to nerves or blood vessels
  • Scar that is sore when you touch it
  • Need for more surgery

Before the Procedure

Before the procedure, tell your surgeon or nurse if:

  • You are or could be pregnant
  • You are taking any medicines, including illicit drugs, supplements, or herbs you bought without a prescription
  • You have been drinking a lot of alcohol, more than 1 or 2 drinks a day

Planning for your surgery:

  • If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see the provider who treats you for these conditions.
  • If you smoke, it's important to cut back or quit. Smoking can slow healing and increase the risk for blood clots. Ask your provider for help quitting smoking.
  • If needed, prepare your home to make it easier to recover after surgery.
  • Ask your surgeon if you need to arrange to have someone drive you home after your surgery.

During the week before your surgery:

  • You may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
  • Ask your surgeon which medicines you should still take on the day of surgery.
  • Let your surgeon know about any illness you may have before your surgery. This includes COVID-19, a cold, flu, fever, herpes breakout, or other illness. If you do get sick, your surgery may need to be postponed.

On the day of surgery:

  • Follow instructions about when to stop eating and drinking.
  • Take the medicines your surgeon told you to take with a small sip of water.
  • Follow instructions on when to arrive at the hospital. Be sure to arrive on time.

After the Procedure

After the surgery:

  • Your elbow and arm will likely have a thick bandage or a splint.
  • You can go home when the effects of the sedative or general anesthesia wear off.
  • Follow instructions on how to care for your wound and arm at home. This includes taking medicine to ease pain from the surgery.
  • You should begin moving your arm gently, as recommended by your surgeon.

Outlook (Prognosis)

Tennis elbow surgery relieves pain for most people. Many people are able to return to sports and other activities that use the elbow within 4 to 6 months. Keeping up with recommended exercise helps ensure the problem will not return.

Open References

References

Adams JE, Steinmann SP. Elbow tendinopathies and tendon ruptures. In: Wolfe SW, Pederson WC, Kozin SH, Cohen MS, eds. Green's Operative Hand Surgery. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 25.

Wolf JM. Elbow tendinopathies and bursitis. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 61.

 

Review Date: 11/7/2024

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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