Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery
Tennis elbow is caused by doing the same repetitive and forceful arm movements. 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.
I'm Dr. Alan Greene and let's talk for a moment about tennis elbow. Tennis elbow is a kind of tendonitis. It's an inflammation and injury to the tendons usually on the outside of the elbow. Tendons are those fibrous bands that connect the muscle into the bone. When those tendons get damaged, as they often can in racquet sports or also in baseball, sometimes over using a screwdriver, a lot of ways you can do it, we typically call it tennis elbow or tendonitis. How do you prevent it? When you are playing tennis one of the most important things is to avoid putting too much stress on that tendon on the outside of the elbow. The problem usually comes with your backhand. So if you do a two-handed backhand, you can greatly reduce the stress. You can also reduce the stress by using a racquet that has the right size grip for your hand. Don't play with somebody else's racquet very often. And make sure the strings are not over tightened. It puts too much stress when the ball hits suddenly with over tightened strings. If you have a tendency to get tennis elbow, it could also be very useful immediately after playing to ice the elbow and take some ibuprofen to prevent swelling and inflammation. Now, if you do develop tennis elbow how do you treat it? It comes down to a combination of rest, ice, compression, and elevation. In terms of rest, you want to completely rest your elbow for at least a couple of days and really for as long as it is still sore. In terms of ice that first day, ice very frequently. It's great even every 15 minutes to have an ice pack on there briefly and for the next couple of days, at least every 3 or 4 hours if you can. It will help speed the healing. Wearing a bandage on there to help support the elbow is good. It can also be good when you are playing tennis to help prevent tennis elbow. The wrap on there can help support the elbow and keep it warm and make it less likely to injure. And finally when you are having the severe pain at the beginning especially, keeping your elbow elevated above your heart can help as well and hopefully this will get you back out and physically active again very quickly.
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.
Why the Procedure Is Performed
You may need 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.
- You may need to change your practice schedule or duration.
- Taking medicines, such as aspirin, ibuprofen, or naproxen.
- Doing exercises to relieve pain as recommended by the doctor 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 doctor.
Risks of anesthesia and surgery in general are:
- Reactions to medicines or breathing problems
- Bleeding, blood clots, or infection
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
- Tell the surgeon about all the medicines you take, including those bought without a prescription. This includes herbs, supplements, and vitamins.
- Follow instructions about temporarily stopping blood thinners. These include aspirin, ibuprofen, (Advil, Motrin), and naproxen (Naprosyn, Aleve). If you are taking warfarin (Coumadin), dabigatran (Pradaxa), apixaban (Eliquis), rivaroxaban (Xarelto), or clopidogrel (Plavix), talk with your surgeon before stopping or changing how you take these drugs.
- Ask your doctor which medicines you should still take on the day of your surgery.
- Stop smoking, if you smoke. Smoking can slow healing. Ask your health care provider for help.
- Tell your surgeon if you have a cold, flu, fever, or other sickness before your surgery.
- Follow instructions about not eating or drinking anything before surgery.
- Arrive at the surgery center when your surgeon or nurse told you to. 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 effects of the sedative 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.
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.
Adams JE, Steinmann SP. Elbow tendinopathies and tendon ruptures. In: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, Cohen MS, eds. Green's Operative Hand Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017: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.
Last reviewed on: 11/12/2020
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 Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
How long does it take to recover from tennis elbow surgery? ›
You will be able to return to daily activities in about 2 to 6 weeks. You can go back to work in 3 to 12 weeks, depending on your job. You should be able to play sports again in 4 to 6 months.Is surgery a good option for tennis elbow? ›
Studies have not shown that surgery for tennis elbow is better than other treatment. But some people have less pain after surgery. So they are able to do more with their affected arms and hands.How long is the operation for tennis elbow? ›
Tennis elbow release is usually performed under general or increasingly under local anaesthetic. The procedure usually takes 15-30 minutes. Your surgeon will make an incision (cut) along your arm near your elbow. They will inspect the point where your tendon attaches to bone.Is tennis elbow surgery painful? ›
You will have some pain. Your doctor can give you medicine for this. A large bandage will cover your stitches (sutures). Your arm may be in a splint or a cast.How long do you stay in hospital after elbow surgery? ›
You'll usually be in hospital for 2–3 nights after your surgery. During this time medical, nursing, physiotherapy and occupational therapy staff will be involved in your care. You'll be given drugs after the operation to keep your arm as free from pain as possible.Do you have to wear a cast after tennis elbow surgery? ›
– When the procedure is complete, your orthopedic surgeon will place a bandage on your arm to cover the wound and stitches. You may also need to wear a cast or a splint for approximately 7-10 days to help your arm heal. Keep in mind that you will not be able to use your arm during this period.What happens if you dont fix tennis elbow? ›
If left untreated, tennis elbow may become chronic and last for months, even years, especially if you continue the repetitive activity that caused the problem. There may also be nerve entrapment in the forearm, which is why it's important to see a specialist for an accurate diagnosis and appropriate treatment.How can I permanently fix tennis elbow? ›
Surgical or other procedures
- Injections. ...
- Ultrasonic tenotomy (TENEX procedure). ...
On average most people return to driving around 4 weeks following surgery. If a ligament or tendon has been repaired, you need to wait until the tendon/ ligament has healed – normally around 8-10 weeks with a graduated increase in activity.Are you awake during tennis elbow 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.
How long after elbow surgery can I go home? ›
Go home and rest on the first day. Slowly return to your normal activities, and follow the instructions below regarding your operated elbow. If you had a regional block (if your elbow or arm was frozen), it will take 4 to 12 hours for the feeling to return to normal. The operated area will feel numb and weak.Is elbow surgery a major surgery? ›
Elbow replacement is major surgery with serious risks and potential complications. You may have less invasive treatment options.How long do you have to wear a sling after elbow surgery? ›
During the first 2 weeks, you may remove your sling at home during the day but need to wear the sling in public (around other people) and when sleeping. After 2 weeks, the sling can be removed at all times.Is tennis elbow a permanent injury? ›
Tennis elbow can turn into a chronic problem if not treated by a professional. Oftentimes, people who develop tennis elbow may not see a doctor and attribute it to just getting older. They may rest, take pain-relievers, and get back in the game without proper rehabilitation.How long does elbow surgery usually take? ›
During the procedure
Most people get general anesthesia and a nerve block. General anesthesia puts you into a deep sleep. The nerve block numbs your arm so that pain control can continue after you wake up from general anesthesia. The surgery usually takes 1 to 2 hours.
Kodama et al.21,22) reported survival rates of 87.8% at 5 years and 70.7% at 10 years, and the most common complication was aseptic loosening.When can I return to work after elbow surgery? ›
You should be able to go back to work 6 to 12 weeks after your surgery. If you use your elbow a lot at work, you might have to make adjustments on your job. For example, you might not be able to lift heavy objects. You'll need to wait about 4 to 6 months before you can exercise and play sports again.How do you know if your elbow needs surgery? ›
Signs that you need elbow surgery include consistent and severe pain in the elbow joint, pain that worsens with use, stiffness after rest or activity, and a limited range of motion.How do you lay down after elbow surgery? ›
The best position is lying down with two pillows under your arm or with your arm in a Carter pillow (if provided). Elevation should be done for the first several days after surgery. 3. Pain Medication: Take medications as prescribed, but only as often as necessary.Is it better to keep tennis elbow straight or bent? ›
Start with your elbow bent, which is less painful, then progress to keeping your elbow straight. Hold a 1 pound weight in the hand. Using the unaffected hand, lift the hand with the weight toward the body, bending the wrist (keep the arm flat against the table).
Should I get an MRI for tennis elbow? ›
The short answer is that an MRI is probably neither necessary nor useful for most early and mid-term Tennis and Golfer's Elbow sufferers (and even some chronic / long-term sufferers, who don't intend to consider surgery.)Does a cortisone shot help tennis elbow? ›
“The traditional treatment for lateral epicondylitis, or tennis elbow, is to use physical therapy followed by a cortisone injection to relieve pain,” Dr. Scofield explains. “Cortisone injections are popular because they've been used for decades, they are affordable, and insurance covers them.Should I lift weights with tennis elbow? ›
Short answer: Yes, you can still lift weights if you have tennis elbow – provided you do so in a way that is pain-free.Do compression sleeves help tennis elbow? ›
One of the most significant advantages of compression sleeves is their multifaceted benefits, especially for tennis elbow. From increased blood circulation to added support and relieving tension and pressure, there is a range of benefits tennis players may experience.Why won't my elbow tendonitis go away? ›
Most likely because it is REALLY HARD to offload an elbow tendon that you use every day for simple things, like pouring a kettle, opening doors and having a drink. When a tendon is irritated enough to cause pain doing these normal activities, it needs a lot of time and patience to settle down.How long do you need pain meds after elbow surgery? ›
Use continuously for 3 days and then as needed. Naproxen 500 (2 Aleve) every 12 hours OR ibuprofen 800 (4 Advil) every 8 hours. Take with food and avoid if history of ulcers, severe reflux or kidney disease. Continue for 5 days and then as needed.Can you move your fingers after elbow surgery? ›
You should begin moving your fingers the first day after surgery. You have been given a long acting local anesthetic around the incision. It will often last 6-8 and sometimes as long as 12 hours.How do I prepare for elbow surgery? ›
Do not eat or drink before the surgery as directed. In some cases, physical therapy or specific exercises will be prescribed prior to a scheduled procedure, to help build up muscle strength around the affected area. Take your medication as directed.What are the risks of elbow surgery? ›
- Nerve damage.
- Joint stiffness (common)
- Joint instability.
- Bone misalignment.
- Complications from anesthesia.
- Broken screws or plates.
Arthroscopic Surgery for Tennis Elbow is the gold standard and best in class surgical. With arthroscopic (keyhole) techniques, the results are the same as open procedures, but with additional advantages. Advantages of Arthroscopic Surgery for Tennis Elbow: Smaller incisions, thus less post-operative pain.
How common is tennis elbow surgery? ›
Surgery is considered a last resort for this condition and only 1 in 10 patients requires surgical intervention. The surgical success rate for relieving Tennis Elbow pain is 85-95%. Your surgeon will decide whether to perform your surgery in the traditional manner or endoscopically.What should I wear at home after elbow surgery? ›
You will find it more comfortable to wear loose clothing to avoid pressure on the incision. Ask your doctor or other qualified health professional about appropriate wound care. You may want to place a pillow behind your elbow when seated or lying down to keep the surgery area forward to help decrease pain.What position are you in for elbow surgery? ›
Currently, the majority of arthroscopic procedures are performed in either the lateral decubitus or supine suspended position.What is the most common elbow surgery? ›
- Open elbow surgery. The most commonly performed tennis elbow repair surgery, open elbow surgery can usually be done on an outpatient basis at a surgical center. ...
- Arthroscopic elbow surgery. This minimally invasive, same-day outpatient procedure is preferred by some patients.
A forearm band or strap wrapped around the forearm just below the elbow may provide significant relief. This rests the inflamed tendon. People with severe pain may have the elbow immobilized in a sling or splinted at a 90-degree angle, although the elbow should not be immobilized for prolonged periods.Does tennis elbow ever fully heal? ›
Tennis elbow will get better without treatment (known as a self-limiting condition). Tennis elbow usually lasts between 6 months and 2 years, with most people (90%) making a full recovery within a year. The most important thing to do is to rest your injured arm and stop doing the activity that caused the problem.How long does it take to get full range of motion after elbow surgery? ›
Giannicola et al.7 report that 70% of patients recovered functional range between 3 months and 6 months post injury, with recovery of flexion being slowest to improve. Thereafter, improvement occurred at a slower rate, until 12 months post injury, when 80% of patients had recovered functional range.When do I need surgery for tennis elbow? ›
Your doctor might recommend surgery if: You have elbow pain after more than 6 to 12 months of tendon rest and rehabilitation. You can't do your job or daily activities because of elbow pain. You have had corticosteroid shots and still have elbow pain.Are you awake for tennis elbow 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.What can you not do after elbow surgery? ›
The most common restrictions after elbow surgery involve not lifting heavy objects with the affected arm and not using it to push or pull — like opening doors or getting up from a chair. It's also likely that you won't be able to drive for a short period.
Can you drive after having elbow surgery? ›
Driving After Arthroscopic Surgery (Key-Hole Elbow & Shoulder Surgery) If you have had key-hole surgery where no tendon or ligaments have needed repair, immediate movement is encouraged and you can drive once physically able. On average most people return to driving around 4 weeks following surgery.How do you sleep in bed after elbow surgery? ›
How to Sleep while Recovering from Elbow Surgery. To prevent swelling in the hand and arm overnight, be sure to sleep on your back. Your arm should be propped up on a pillow or cushion throughout the night to keep it elevated and prevent fluid accumulation.