Lateral Epicondylitis Surgery

Lateral epicondylitis, also known as tennis elbow, is a condition characterized by pain and inflammation on the outside of the elbow, where the muscles and tendons of the forearm attach to the lateral epicondyle. Surgery may be considered when conservative treatments have failed to provide relief.

Indications for Surgery

Surgery is typically recommended for patients with severe lateral epicondylitis who have not responded to at least 6-12 months of conservative treatment, including rest, physical therapy, and pain management. Indications for surgery include:

• Persistent pain and limited function
• Failed response to conservative treatments
• Significant impairment in daily activities or sports participation

Surgical Procedures

There are several surgical procedures used to treat lateral epicondylitis, including:

• Open release surgery: This involves making an incision on the outside of the elbow to release the affected tendons and remove any damaged tissue.
• Arthroscopic surgery: This is a minimally invasive procedure that uses a small camera and instruments to visualize and treat the affected area through several small incisions.
• Percutaneous release surgery: This involves using a needle or other instrument to release the affected tendons through a small puncture in the skin.

Surgical Techniques

The surgical technique used may vary depending on the individual case and the surgeon's preference. Some common techniques include:

• Release of the extensor carpi radialis brevis (ECRB) tendon: This involves releasing the ECRB tendon, which is often implicated in lateral epicondylitis.
• Debridement of the lateral epicondyle: This involves removing any damaged or inflamed tissue from the lateral epicondyle.
• Decompression of the radial nerve: This involves relieving pressure on the radial nerve, which may contribute to symptoms of lateral epicondylitis.

Postoperative Care and Rehabilitation

After surgery, patients typically require a period of rest and rehabilitation to allow the affected tissues to heal. This may include:

• Pain management: Patients may be prescribed pain medication to manage discomfort after surgery.
• Immobilization: The elbow may be immobilized in a splint or cast to protect the affected area and promote healing.
• Physical therapy: Patients typically require physical therapy to regain strength, flexibility, and range of motion in the affected arm.

Risks and Complications

As with any surgical procedure, there are risks and potential complications associated with lateral epicondylitis surgery. These may include:

• Infection: As with any surgical procedure, there is a risk of infection with lateral epicondylitis surgery.
• Nerve damage: There is a risk of nerve damage during surgery, which may result in numbness, tingling, or weakness in the affected arm.
• Recurrence of symptoms: In some cases, symptoms of lateral epicondylitis may recur after surgery.

Outcomes and Prognosis

The outcomes and prognosis for lateral epicondylitis surgery are generally good, with most patients experiencing significant improvement in symptoms and function. However, the success of surgery depends on various factors, including the severity of the condition, the effectiveness of postoperative rehabilitation, and the presence of any underlying conditions that may affect healing.