If you have ever had tennis elbow for awhile, your doctor may have recommended tennis elbow surgery. It’s best that you know what happens during surgery, rather than have the doctor plunge right in and do it – and find out later what may have gone wrong!
Not Everyone Has Lateral Epicondylitis Surgery
The first thing to know is that physicians only advise patients to have tennis elbow surgery procedures when other treatments such as those listed below have failed.
- Bracing (immobilization)
- Physical therapy and rehabilitation
- Cortisone injections
- Shock wave therapy
- Platelet-rich plasma
- Low-dose thermal ablation
In these cases, the person has been suffering for months and sometimes years with his tennis elbow. He secretly wishes that surgery could be performed to take away his pain.
The second thing to know is that the muscle or tendon that is operated on is the extensor carpi radialis tendon. The muscle itself ends in a tendon and either part of it may be repaired during surgery.
Different Types Of Elbow Tendonitis Surgery
The most three most common types of tennis elbow surgery procedures are ones that use methods to release the extensor tendon: open, percutaneous, or arthroscopic.
1. Open Lateral Epicondylitis Surgery
Open surgery is surgery where the surgeon cuts open the skin and exposes the area. The repair is done by re-connecting the muscle under local anesthesia.
2. Percutaneous Elbow Surgery
Percutaneous surgery is surgery done when a needle punctures the skin. When surgery is done in this manner, there’s only a small hole in the skin, which seals and heals easily. The open area isn’t prone to as much infection as that from an open surgical procedure.
3. Arthroscopic Lateral Epicondylitis Surgery
Arthroscopic surgery is when an endoscope is inserted into a joint to treat the damage to a joint. The surgeon can view a video screen and watch where the surgical instruments he is using touch different anatomical structures.
Arthroscopy is used frequently for knee, wrist, ankle, foot, shoulder, and hip injuries besides for tennis elbow.
Studies On Tennis Elbow Sugery Quite Interesting
After going to the medical literature to read the studies on the topic of lateral epicondylitis surgery, several studies came up that I thought you should be aware of.
The first one – a review study – comes out of Australia. Here’s what the researchers found:
▸ When open ECRB surgery (extensor carpi radialis brevis) was compared to radiofrequency microtenotomy, pain was less in the radiofrequency microtenotomy surgery for tennis elbow.
In this 20-minute surgery, a surgical instrument that looks like a pen delivers low temperature radiofrequency energy with saline. A gas forms at the tip of the pen and contacts the damaged tissues which induces a healing response. (Source: Cochrane Database Syst Rev. 2011 Mar 16;(3):CD003525.)
▸ No difference in pain or tenderness on palpation was found between open ECRB surgery and surgery that involved decompression of the posterior interosseous nerve.
▸ One study found that those who received percutaneous release rather than tennis elbow surgery that involved open release of the ERCB muscle had better elbow function afterwards. (Cochrane Database Syst Rev. 2011 Mar 16;(3):CD003525.)
▸ Another study found comparable results between open surgical release of the ECRB and botulinum toxin injection at two years follow up. The botulinium toxin injection is another example of a tennis elbow surgery procedure done during the surgery. (Source: Cochrane Database Syst Rev. 2011 Mar 16;(3):CD003525.)
▸ One trial found that extracorporeal shock wave therapy (ESWT) for lateral epicondylitis seemed to improve the pain the tennis elbow sufferers felt at night but overall there was no difference when compared with percutaneous tenotomy at the one-year mark.
The ESWT is where a shockwave is applied to the area, which induces the healing process.
(Source: Cochrane Database Syst Rev. 2011 Mar 16;(3):CD003525.)
So are you thinking what I’m thinking? Are you wondering about the effectiveness for elbow tendonitis surgery? It’s not reported in the literature so far.
Let’s look at a few more studies.
▸ In a French study, reported in December 2010, (Source: Chir Main. 2010 Dec;29(6):373-7. Epub 2010 Oct 14.) surgeons injected fat into the elbow of eight patients in lateral epicondylitis surgery. All other methods had failed for the eight patients who participated. Five patients had improvement in their pain.
▸ In a study in Egypt, the researchers found that half of the patients who had arthroscopic surgery were pleased with the results, whereas only 37% who had percutaneous surgery were satisfied. (Source: Arch Orthop Trauma Surg. 2011 Mar;131(3):383-8. Epub 2011 Jan 21.)
The scientists reported that arthroscopy led to better functioning of the elbow but it is a more difficult type of surgery to do than percutaneous surgery.
Tennis Elbow Is Not An Inflammation, Say The Docs
In March 2010 Doctors at Tulane University School of Medicine in New Orleans reported that lateral epicondylitis is no longer thought to be caused by inflammation. When the extensor carpi radialis brevis tendon was examined under the microscope, they didn’t see an inflammation of any kind.
They reported here that arthroscopic techniques worked better than other surgeries because the surgeon has the ability to visualize and then repair any problems that he sees.
(Source: J Shoulder Elbow Surg. 2010 Mar;19(2 Suppl):31-6.)
Open Tennis Elbow Surgery Works
A New Zealand study reported that the open technique offers excellent results with very few complications when they followed up 10 years later. They had reviewed cases of 158 people who all used the same surgeon.
The average age of the patients were 42 years old. The results were good to excellent in 95% of the patients. None of the patients needed any additional surgery.
(Source: J Shoulder Elbow Surg. 2010 Apr;19(3):363-7. Epub 2009 Dec 11.)
However, another study found that there was a 98% success rate in open muscle resection for elbow tendonitis surgery. The surgery was done under local anesthesia.
In two cases, people had joint fluid that leaked but additional surgery with suction drainage took care of it. (Source: Clin Orthop Surg. 2009 Sep;1(3):123-7. Epub 2009 Aug 17.)
Grafting The Tendon Is A Tennis Elbow Surgery Procedure, Too
Grafting the tendon can also be done during surgery. At the Mount Sinai School of Medicine in New York, 24 tendon grafting surgeries were followed up on five years later. All patients reported good or excellent results.
But really, the best way to approach the whole topic of tennis elbow surgery is to get down to business and start doing tennis elbow exercises, which are very effective.
For best results, start with the ebook, Tennis Elbow Secrets Revealed.